Clinicopathologic Features and Radiation Therapy for Metaplastic Carcinoma of the Breast

轉化型乳癌的臨床病理特徵與放射線治療

10.6316/TRO/201421(4)277

詹凱翔(Kai-Hsiang Chan)；陳文宗(Wen-Chung Chen)；賴俞璇(Yu-Hsuan Lai)；陳紘玉(Hung-Yu Chen)；陳海雯(Helen H. W. Chen)

轉化型乳癌 ； 放射治療 ； 臨床病理特徵 ； 臨床治療成果 ； Metaplastic carcinoma of the breast ； Radiation therapy ； Clinicopathologic features ； Clinical Outcome

放射治療與腫瘤學

21卷4期（2014 / 12 / 01）

277 - 284

英文

目的：轉化型乳癌（MCB）是一種罕見的乳癌亞型，其特徵在於腫瘤同時有上皮和間質細胞的組織學成分存在。本研究的目的在於評估此一族群病人的臨床病理特徵和接受放射線線治療的成果。材料與方法：研究在我們醫院接受以治癒為目的放射線治療且無遠處轉移的MCB病人，收集其臨床病理特徵並分析其治療結果，我們採用Kaplan-Meier統計方法來分析這群病人的無病存活率（DFS）及整體存活率（OS）。結果：自西元1996至2012年間，符合納入條件的病人有12位。患者年齡介於29至66歲（中位數為48），原發腫瘤大小中位數為5.3公分（範圍1.2-19），無淋巴結轉移者有9位病人（75%），在10位已知受體狀況的病人中，9名患者有三陰性的腫瘤（即ER陰性、PR陰性和HER2陰性），9位患者接受全乳房切除術，3名患者接受乳房保留手術。放射線的劑量從50-66Gy不等（中位數60Gy），治療後沒有病人局部復發。無病存活的中位數為4.2年，五年的整體存活率為52.5%。結論：我們研究顯示放射線治療，是MCB患者局部腫瘤控制的一種非常有效的輔助治療。

Purpose: Metaplastic carcinoma of the breast (MCB) is a rare subtype of breast cancer and characterized by the histologic presence of two or more cellular types of epithelial and mesenchymal components. The purpose of the study is to review the clinicopathologic features and outcomes of MCB treated with radiation therapy (RT) at our institution. Materials and Methods: Patients with MCB of the breast who did not have distant metastasis at diagnosis and received curative-intent RT at our institution were identified. Clinicopathologic features were collected and outcomes were analyzed. We used Kaplan-Meier statistic method to estimate local control, disease-free survival (DFS) and overall survival (OS) in these patients. Results: From 1996 to 2012, twelve MCB patients who met the inclusion criteria were enrolled. Patient age ranged from 29 to 66 years (mean, 48). The median tumor size was 5.3 cm (range, 1.2-19). Nine patients (75%) were nodal negative. Triple negative tumors (ie, ER negative, PR negative and HER2 negative) were found in 9 of 12 patients (75%). Nine patients received mastectomy while 3 patients underwent breast conserving surgery. RT dose ranged from 50-66 Gy (mean, 60). No patient developed local recurrence after RT. The median DFS was 4.2 years. Overall survival was 52.5% at 5 years. Conclusions: Our findings suggest adjuvant RT is a very effective adjuvant treatment on local tumor control for patients with MCB.