Metaplastic Breast Cancer and EGFR Expression

Aim: Metaplastic breast cancer has poor prognosis and is usually triple negative. Although it is morphologically more heterogeneous than triple negative breast cancers, expression profile is more homogeneous. In this study, we investigated our metaplastic breast cancer cases regarding their pathology and clinical characteristics. Material and Method: 16 metaplastic breast cancer cases from four different center were included in the study. Pathology and clinical characteristics of the cases were evaluated retrospectively. Results: All the cases are female and median age is 48 . Tumor is commonly localized to the outer quadrant and mean diameter of the mass is 37.5 mm. Tumor diameter is 20-50 mm in 3 (10.51%) of the cases. Only 4 (16.1%) patients have axillary lymph node involvement. When considering histological subtypes, five of the cases has squamous cell, five of them has spindle cell, one of them has mucoepidermoid, and in five cases the subtype was not identified. Considering hormone receptor status ER and PR was negative in 78.9%, 63.2% respectively. HER2 protein expression was positive by immunohistochemical staining in 1 (5.3%) case. CK5/6 and CK17 was both positive in 7 (36.8%) cases. EGFR expression was positive in 4 (21.1%) cases, was negative in 5 (26.3%) cases and not identified in 7 (36.8%) cases. Three of the cases were offered neoadjuvant chemotherapy. As neoadjuvant chemotherapy, anthracycline and taxane combination (n:2 TAC, n:1 AC-paclitaxel) was preferred. Mean follow-up was 41 months. Mean survival was 42.4 months in EGFR negative patients and 47.5 months in EGFR positive patients. This difference was not statistically significant. During follow-up 3 cases had recurrence. Discussion: EGFR expression is seen in metaplastic breast cancer. Although EGFR expression is related to poor prognosis, it is not a predictive marker. Therefore, predictive molecular markers are required for new approaches in treatment.

Özet

Amaç: Metaplastik meme kanseri kötü prognozlu bir kanser olup sıklıkla triple negatifdir. Ancak triple negatif meme kanserlerine göre morfolojik olarak daha heterojen olmasına rağmen, ekspresyon profili daha homojendir. Bu çalışmada metaplastik meme kanserli olgularımızın patolojik ve klinik özelliklerini incelemeyi amaçladık. Gereç ve Yöntem: Çalışmaya dört farklı merkezden metaplastik meme kanseri tanılı 16 olgu dahil edildi. Olguların patolojik ve klinik özellikleri retrospektif olarak değerlendirildi. 15 olgunun patolojik preperatları Uludağ Üniversitesi Tıp Fakültesi Patoloji bölümünde yeniden incelendi ve metaplastik meme kanseri tanısı doğrulandı. Bir olgunun patolojik preperatlarına erişilemedi. Bulgular: Olguların tamamı kadın olup ortanca yaş 48 idi. Tümör sıklıkla dış kadranda lokalize olup ortalama çap 37.50 mm idi. Tümör çapı olguların 3'de (%15.8) 20-50mm saptandı. Aksiller lenf nodu tutulumu sadece 4 hastada (%16.1) mevcuttu. Histopatolojik alt tipler incelendiğinde; olguların 5'i squamöz hücreli, 5 spindle hücreli, 1 mukoepidermoid olup 5 olguda alt tip belirtilmemişti. Hormon reseptör durumu incelendiğinde; ER %78.9, PR %63.2 oranında negatifti. HER2 protein ekspresyonu immunohistokimyasal olarak 1(%5.3) olguda pozitif saptandı. CK5/6 olguların 7'de (%36.8), CK17 ise 7 (%36.8) olguda pozitifti. EGFR ekspresyonu olguların 4'de (%21.1) pozitif, 5'de (%26.3) negatif iken 7'de (%36.8) belirtilmemişti. Olguların 3'ne neoadjuvan kemoterapi önerilmişti. Neoadjuvan tedavide antrasiklin ve taksan kombinasyonlu rejimler (n:2 TAC, n:1 AC-Paklitaksel) tercih edilmişti. Ortalama takip süresi 41 aydı. EGFR negatif hastalarda ortalama sağ kalım 42.4 ay iken, EGFR pozitif hastalarda sağ kalım 47.5 ay olup istatistiksel olarak fark yoktu. Bu takip süresinde 3 olguda nüks saptandı. Tartışma: Metaplastik meme kanserinde EGFR ekspresyonu mevcuttur. EGFR ekspresyonu kötü prognozla ilişkili olsada prediktif bir markır değildir. Bu nedenle tedavide yeni yaklaşımlar için prediktif moleküler belirteçlere ihtiyaç vardır.

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Cite This Article

AVCI, N., KURT, E., AYDIN, T., EVRENSEL, T., ULAŞ, A., OVEN, B. B. U., ORDU, Ç., TOLUNAY, Ş. (2022). Metaplastic Breast Cancer and EGFR Expression. Journal of Clinical and Analytical Medicine, Cilt: 6 - Sayı: 5, 616–619. https://ajindex.com/articles/561078

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