Biologic distinctions and therapeutic implications of sarcomatoid metaplasia of epithelial carcinoma of the breast.

摘要: Background Malignant sarcomatoid metaplasia of epithelial carcinoma the breast (carcinosarcoma) is diagnosed at an annual rate two cases per 107 women in United States America. It seems that these tumors behave differently than other carcinomas or sarcomas breast. Study design The University Texas M. D. Anderson Cancer Center experience (1947 to 1991) treating 50 patients (mean age years, range 25 76 years) was retrospectively reviewed. five-year overall survival and disease-free rates were compared prognostic factors identified. Results 43 percent lower had been expected for No patient with stage IV disease survived five years. Tumor size diagnosis strongest impact on outcome. axillary lymph node status prognosis less expected. Hormonal receptor levels positive only 12.5 tested. Mastectomy adjuvant chemotherapy radiotherapy, both, superior mastectomy alone wide local excision without therapy, particularly II disease. If complete surgical resection possible, approach treatment recurrent better any modality. Conclusions Carcinosarcoma biologically conventional characteristics dominate clinical course. These biologic distinctions should direct toward a multimodality includes sarcoma-oriented radiotherapy.