Aga Khan University Hospital, Karachi, Pakistan
Dr. Zarka Samoon has completed her M.B.B.S, followed by MRCP in medicine and MRCP in medical oncology. She is a medical oncology faculty at Aga Khan University Hospital with keen interest in breast and female genital tract malignancies.
Metaplastic breast carcinoma (MBC) is a rare disease with an incidence of <1%. In comparison to invasive ductal carcinomas (IDC), MBC present with a larger tumor size, few nodes involved, mostly high grade and triple negative, and with a shorter overall survival.
Objectives To determine the progression free, and overall survival of patients with MBC.
Methods From July 2006 till June 2013, 32 patients with MBC treated at Aga Khan University Hospital, Karachi were identified and retrospectively reviewed. Kaplan-Meier method was used for survival analysis.
Results Prevalence of MBC was 1.92% among breast cancer patients. The median age at tumor diagnosis was 54 years. Twenty nine (90.6%) patients had grade III tumor. The most common histopathology was squamous (65.6%) followed by spindle (12.5%) and carcinosarcoma (9.4%). Median tumor size was 4.5 cm. Seventeen (53.1%) patients had nodal involvement. Two patients (6.2%) had metastatic disease at presentation. Hormone receptors were positive in 16 (50%) patients and negative in 15 (46.9%) patients. Her-2 neu receptor was positive in 3 (9.4%) patients. Twenty seven (84.4%) patients underwent modified radical mastectomy. Neoadjuvant and adjuvant chemotherapy (anthracycline based in most cases) was received by 10 (31.25%) and 15 (46.8%) patients respectively. The median progression free and overall survival was 26 months and 27 months respectively. Five year progression free and overall survival was 72% and 73% respectively.
Our patients had tumors which were mostly high grade, large, with around half of them having nodal and hormonal involvement however with better survival outcomes compared to series described earlier.