Introduction:
Breast cancer is a complicated and varied condition with several subtypes, each with unique traits, prognoses, and therapeutic options. One rare and particularly aggressive subtype is metaplastic breast cancer (MBC). This subtype is difficult to research and comprehend since it only makes up a small portion of all breast cancer occurrences.
What Is Metaplastic Breast Cancer?
Metaplastic breast cancer is a rare form that exhibits features of both epithelial and mesenchymal cells. This subtype is characterized by the presence of both glandular (epithelial) and non-glandular (mesenchymal) components within the tumor. The mesenchymal components often resemble cells found in connective tissue, such as cartilage or bone. This unique combination of cell types distinguishes metaplastic breast cancer from other breast cancer subtypes.
What Is the Prevalence and Incidence of Metaplastic Breast Cancer?
Less than 1 % of all breast cancer diagnoses are metaplastic, making it an uncommon disease. It tends to affect older women, and its incidence increases with age. However, it can occur in women of all ages, including those in their 30s and 40s. The rarity of this subtype makes it challenging to conduct extensive research and develop targeted treatments.
What Is the Clinical Presentation of Metaplastic Breast Cancer
The precise features of the tumor frequently determine the clinical appearance of metaplastic breast cancer, which can vary greatly. Typically, patients with metaplastic breast cancer may present with a palpable breast lump, a common early sign of breast cancer across various subtypes. This lump may vary in size and density and is usually painless, though some patients may experience tenderness or discomfort in the affected breast.
In addition to the palpable lump, patients may notice changes in breast shape or contour. The affected breast might appear swollen, larger, or asymmetric compared to the unaffected breast. Skin changes over the breast can also occur, such as dimpling or thickening, resembling an orange peel (peau d'orange). These changes are due to the tumor's growth and its effect on the surrounding tissues. Nipple abnormalities may also be observed, including retraction or inversion of the nipple. Discharge from the nipple, which may be bloody or clear, could be present in some cases. Any unexplained changes in the breast, nipple, or areola should prompt further evaluation and medical attention. Metaplastic breast cancer can occasionally present with symptoms resembling inflammatory breast cancer (IBC). Breast swelling, warmth, and redness are characteristics of the aggressive breast cancer type known as IBC. Patients with metaplastic breast cancer may experience similar inflammatory changes, although they are not as common in this subtype.
What Is the Diagnosis of Metaplastic Breast Cancer?
Accurate diagnosis of metaplastic breast cancer involves a combination of clinical evaluation, imaging studies, and histopathological examination. Imaging techniques like mammography, ultrasound, and magnetic resonance imaging (MRI) help identify the tumor's size, location, and possible spread to nearby lymph nodes. However, a definitive diagnosis is achieved through a biopsy, where a tissue sample is obtained and examined under a microscope.
Histopathological examination of the biopsy sample reveals the characteristic features of metaplastic breast cancer, including the presence of both glandular and non-glandular cell components. Additionally, the biopsy helps determine the tumor's grade, which is essential for treatment planning and predicting the disease's aggressiveness.
What Are the Treatment Strategies for Metaplastic Breast Cancer?
Due to the rarity and aggressive nature of metaplastic breast cancer, a standardized treatment approach is yet to be established. Depending on the tumor's size, grade, stage, and the patient's general condition, treatment strategies are frequently customized. However, treatment typically involves a combination of surgery, radiation therapy, chemotherapy, and, in some cases, targeted therapy.
-
Surgery: Surgery is a primary treatment for metaplastic breast cancer and usually involves either a lumpectomy (tumor removal together with a margin of surrounding tissue) or possibly a mastectomy (complete breast removal). If the cancer has gone to the lymph nodes, it may also be necessary to remove and evaluate the lymph nodes.
-
Radiation Therapy: After surgery, radiation treatment may be used to eliminate any cancer cells that remain and lower the chance of recurrence. It involves the use of high-energy X-rays to target and kill cancer cells.
-
Chemotherapy: Chemotherapy is often recommended for metaplastic breast cancer, especially in advanced or aggressive cases. Chemotherapy drugs aim to kill rapidly dividing cancer cells throughout the body.
-
Targeted Therapy: Some metaplastic breast cancers may overexpress specific receptors or genes, providing potential targets for treatment with targeted therapies. These treatments try to limit harm to healthy cells while preventing the development and spread of cancer cells.
What Is the Prognosis and Challenges for Metaplastic Breast Cancer?
Metaplastic breast cancer is generally associated with a poorer prognosis compared to more common types of breast cancer. The aggressive nature of this subtype, its resistance to conventional treatments, and its tendency to metastasize contribute to the challenges in managing the disease effectively. The prognosis varies based on factors such as the tumor size, grade, stage, and the individual's overall health.
Research is ongoing to better understand the molecular and genetic characteristics of metaplastic breast cancer, which may pave the way for more targeted and effective treatment approaches. In order to evaluate new therapies and tactics to enhance outcomes for people with this uncommon breast cancer subtype, clinical trials are essential.
What Are the Ongoing Research and Future Perspectives of Metaplastic Breast Cancer?
Advancements in genomic and molecular profiling technologies have enabled researchers to delve into the intricate molecular characteristics of metaplastic breast cancer. Researchers aim to develop targeted therapies that can improve treatment efficacy and patient outcomes by identifying specific genetic mutations and alterations unique to this subtype.
Furthermore, ongoing research is focusing on immunotherapies for metaplastic breast cancer. Immunotherapies harness the body's immune system to recognize and destroy cancer cells. Early studies suggest that immune checkpoint inhibitors may hold promise in treating metaplastic breast cancer by enhancing the immune response against the tumor.
Conclusion:
A mix of epithelial and non-glandular cell components characterizes the uncommon and aggressive subtype of breast cancer. Due to its rarity, there is limited understanding of its biology and optimal treatment strategies. However, ongoing research and advancements in medical technologies offer hope for improved outcomes and tailored treatments for individuals diagnosed with this challenging subtype of breast cancer. Effective management of metaplastic breast cancer and improving the quality of life for those affected depend on early identification, precise diagnosis, and diverse treatment modalities.
