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(2): 99619 [DOI: 10.12998/wjcc.v13.i2.99619]
Corresponding Author of This Article
Aikaterini Mastoraki, MD, PhD, Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma Street, Athens 11527, Greece. dr_kamast@yahoo.gr
Research Domain of This Article
Surgery
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 16, 2025; 13(2): 99619 Published online Jan 16, 2025. doi: 10.12998/wjcc.v13.i2.99619
Carcinosarcoma of the breast: Facing the challenge of a rare nosologic entity
Aikaterini Mastoraki, Maria Tsamopoulou, Foivos-Konstantinos Stamatis, Alexios Strimpakos, Ero Mouchtouri, Christiana Panagi, Evgenia Mela, Sotiria Mastoraki, Aristotelis Kechagias, Dimitrios Schizas
Aikaterini Mastoraki, Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens 11527, Greece
Maria Tsamopoulou, Foivos-Konstantinos Stamatis, Christiana Panagi, Evgenia Mela, Sotiria Mastoraki, Dimitrios Schizas, Department of Surgery, National and Kapodistrian University of Athens, Athens 11527, Greece
Alexios Strimpakos, Department of Medical Oncology, Hygeia Hospital, Athens 15123, Greece
Ero Mouchtouri, Department of Radiology, Henry Dunant Hospital Center, Athens 11526, Greece
Aristotelis Kechagias, Department of Surgery, Athens Metropolitan Hospital, Athens 15562, Greece
Author contributions: Mastoraki A and Schizas D designed the overall concept and outline of the manuscript; Strimpakos A, Mouchtouri E, Panagi C, Mela E, Mastoraki S and Kechagias A contributed to the discussion and design of the manuscript; Mastoraki A, Tsamopoulou M, Stamatis FK and Schizas D contributed to the writing, editing the manuscript and review of the literature.
Conflict-of-interest statement: The authors declare that no conflict of interests exists.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aikaterini Mastoraki, MD, PhD, Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma Street, Athens 11527, Greece. dr_kamast@yahoo.gr
Received: July 26, 2024 Revised: October 2, 2024 Accepted: October 20, 2024 Published online: January 16, 2025 Processing time: 104 Days and 22.1 Hours
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.
Core Tip: Carcinosarcoma 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. Since surgical removal of breast Carcinosarcoma does not necessarily ensure patient’s long-term recovery, treatment protocols in the literature include combinations of mastectomy with or without axillary dissection and various postoperative chemo-radiotherapy regimens. Nevertheless, 5-year survival rate is limited.
