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Mastoraki A, Tsamopoulou M, Stamatis FK, Strimpakos A, Mouchtouri E, Panagi C, Mela E, Mastoraki S, Kechagias A, Schizas D. Carcinosarcoma of the breast: Facing the challenge of a rare nosologic entity. World J Clin Cases 2025; 13:99619. [PMID: 39823109 PMCID: PMC11577508 DOI: 10.12998/wjcc.v13.i2.99619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 10/02/2024] [Accepted: 10/20/2024] [Indexed: 11/08/2024] Open
Abstract
Carcinosarcoma (CS), also known as metaplastic breast carcinoma with mesenchymal differentiation, is one of the five distinct subtypes of metaplastic breast cancer. It is considered as a mixed, biphasic neoplasm consisting of a carcinomatous component combined with a malignant nonepithelial element of mesenchymal origin without an intermediate transition zone. Although cellular origin of this neoplasm remains controversial, most researchers declare that neoplastic cells derive from a cellular structure with potential biphasic differentiation. Despite recent research on the therapeutic strategies against CS neoplastic disorders, surgical resection appears the only potentially curative approach. Since CS metastasize by the lymphatic route, axillary assessment with sentinel lymph node biopsy and/or axillary lymph node dissection is always implemented. Nevertheless, the tumor also presents a hematogenous metastatic pattern including pleural, pulmonary, liver, brain and less commonly bone metastases. Thus, surgical removal of breast CS does not necessarily ensure patient's long-term recovery. Moreover, alternative therapies, such as radio- and chemotherapy proved insufficient and 5-year survival rate is limited. Nevertheless, there is evidence that following surgery, the combination of radio and chemotherapy is associated with a better prognosis than either treatment alone. The aim of this review is to evaluate the results of surgical treatment for breast CS with special reference to the extent of its histological spread. Clinical features, histogenesis, morphological and immunochemical findings are discussed, while the role of current diagnostic and therapeutic management of this aggressive neoplasm is emphasized.
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Affiliation(s)
- Aikaterini Mastoraki
- Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens 11527, Greece
| | - Maria Tsamopoulou
- Department of Surgery, National and Kapodistrian University of Athens, Athens 11527, Greece
| | | | | | - Ero Mouchtouri
- Department of Radiology, Henry Dunant Hospital Center, Athens 11526, Greece
| | - Christiana Panagi
- Department of Surgery, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Evgenia Mela
- Department of Surgery, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Sotiria Mastoraki
- Department of Surgery, National and Kapodistrian University of Athens, Athens 11527, Greece
| | | | - Dimitrios Schizas
- Department of Surgery, National and Kapodistrian University of Athens, Athens 11527, Greece
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Kiakou M, Tolia M, Koufopoulos N, Tsapakidis K, Arvanitou E, Konstantinos G, Charalambakis N, Nikolaou M, Matthaios D, Tsoukalas N. A Rare Case of Primary Carcinosarcoma of the Breast. FORUM OF CLINICAL ONCOLOGY 2023. [DOI: 10.2478/fco-2022-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Abstract
Breast carcinosarcoma is a rare malignancy accounting for approximately 0.08–0.2% of all breast tumours. It is a type of metaplastic mammary carcinoma displaying biphasic differentiation with epithelial and mesenchymal cellular characteristics with probable derivation from myoepithelial cells.
A 65-year-old woman presented to our hospital with a two-month history of a rapidly growing mass in her left breast. Neither her medical nor family history was positive for malignancies. Subsequently, she underwent a fine needle aspiration, which was positive for adenocarcinoma, followed by a lumpectomy with axillary lymph node dissection. The histology revealed an undifferentiated neoplasm and the immunohistochemical cell staining was positive for pan-cytokeratin, SMA, Vimentin, and S-100, suggesting the diagnosis of breast carcinosarcoma with a triple-negative immunophenotype. There was no evidence of metastasis except for a positive lymph node, indicating a stage IIIA disease. Thus, she received adjuvant chemo-radiotherapy. However, 16 months later, she presented with metastatic disease, and unfortunately, she died 4 months later due to a systemic infection.
Aggressive behavior, higher staging, chemoresistance, and higher proportion of triple negative breast cancer seem to be the main characteristics of breast carcinosarcoma, which is recognised as a separate entity from common invasive ductal carcinoma, with significantly worse clinical outcomes.
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Singh GK, Singh P, Bhowmik KT. Carcinosarcoma (Metaplastic Carcinoma) Breast: A Rare and Aggressive Primary – Report of Two Cases with Review of Literature. Indian J Med Paediatr Oncol 2018. [DOI: 10.4103/ijmpo.ijmpo_27_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractCarcinosarcoma (CS) also known as metaplastic carcinoma of the breast is a rare and aggressive type of malignancy with controversial origin. Currently, there are no standard treatment guidelines outlined, owing to the rarity of the disease, but according to the available literature, surgery followed by adjuvant radiation therapy has the greatest benefit. We are presenting two cases of CS of breast developing metastasis. One of the cases presented with lung metastasis during the course of follow-up and responded significantly to chemotherapy, and the other is currently receiving chemotherapy. The cases are being presented here along with the literature review enlightening the current knowledge and available treatment options.
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Affiliation(s)
| | - Pragya Singh
- Department of Pathology, VMMC and Safdarjung Hospital, New Delhi, India
| | - KT Bhowmik
- Department of Radiotherapy, VMMC and Safdarjung Hospital, New Delhi, India
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Qu X, Zhao B, Hu M, Ji Z, Xu J, Xia W, Qu Y. Downregulation of TBC1 Domain Family Member 24 (BC1D24) Inhibits Breast Carcinoma Growth via IGF1R/PI3K/AKT Pathway. Med Sci Monit 2018; 24:3987-3996. [PMID: 29893377 PMCID: PMC6029514 DOI: 10.12659/msm.906736] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND TBC1 domain family member 24 (TBC1D24) pathogenic mutations affect its binding to ARF6 and then result in severe impairment of neuronal development. However, there are no reports about the expression and function of TBC1D24 in cancer. The aim of the present study was to evaluate the effect of proliferation, migration, and invasion after silencing TBC1D24 expression in breast cancer MCF-7 cells, and to elucidate the potential mechanism of TBC1D24 in breast cancer. MATERIAL AND METHODS The expression of TBC1D24 in breast cancer tissues and the adjacent non-tumor tissues was determined by S-P immunohistochemistry. The malignant behavior, including proliferation, migration, and invasion ability, was determined after silencing TBC1D24 in breast cancer MCF-7 cells. The expression of IGF1R was determined after silencing TBC1D24. The expression of TBC1D24 and IGF1R was detected after transfecting miR-30a mimics or inhibitors. The effect of TBC1D24 on MCF-7 cells growth in vivo was evaluated by a tumor xenograft study. RESULTS TBC1D24 expression was elevated and was associated with poor outcome in breast carcinoma. TBC1D24 high expression was significantly correlated with unfavorable OS and RFS for breast cancer patients (p<0.05). Silencing TBC1D24 inhibited the proliferation, migration, and invasion ability of MCF-7 cells. TBC1D24 and IGF1R expression were decreased when transfected with miR-30a mimics. However, TBC1D24 and IGF1R expression were increased when transfected with miR-30a inhibitors (p<0.05). Knockdown of TBC1D24 inhibited the expression of IGF1R, PI3K, and p-AKT (p<0.05). Knockdown of TBC1D24 abolished tumorigenicity of MCF-7 cells. The average volume and weight of tumors was lower after silencing TBC1D24 expression (P<0.05). CONCLUSIONS Silencing TBC1D24 inhibited MCF-7 cells growth in vitro and in vivo. TBC1D24 promoted breast carcinoma growth through the IGF1R/PI3K/AKT pathway. TBC1D24 is a potential therapeutic target for breast cancer.
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Affiliation(s)
- Xiusheng Qu
- Department of Radiotherapy and Chemotherapy, First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China (mainland)
| | - Bin Zhao
- Department of Anus and Intestine Surgery, First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China (mainland)
| | - Min Hu
- Department of General Surgery, First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China (mainland)
| | - Zhiwu Ji
- Department of Anus and Intestine Surgery, Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China (mainland)
| | - Jian Xu
- Department of General Surgery, First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China (mainland)
| | - Weibin Xia
- Department of General Surgery, First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China (mainland)
| | - Yikun Qu
- Department of General Surgery, First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China (mainland)
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Ghilli M, Mariniello DM, Fanelli G, Cascione F, Fontana A, Cristaudo A, Cilotti A, Caligo AM, Manca G, Colizzi L, Naccarato AG, Roncella M. Carcinosarcoma of the Breast: An Aggressive Subtype of Metaplastic Cancer. Report of a Rare Case in a Young BRCA-1 Mutated Woman. Clin Breast Cancer 2016; 17:e31-e35. [PMID: 27697421 DOI: 10.1016/j.clbc.2016.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 08/05/2016] [Accepted: 08/14/2016] [Indexed: 01/31/2023]
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