ABSTRACT

Aims:

Metaplastic breast carcinoma is an infrequent kind of breast carcinoma, more aggressive and has poorer prognosis than other breast carcinomas. With this case report, we aim to reveal pathologic and clinical features of the metaplastic breast carcinoma and its similarities to ductal invasive carcinoma. However its differentation is possible and should not be skipped in diagnosis.

Case Report:

A BIRADS category of 4c mass that measured 38x31 mm in the ultrasonography was detected in a 71-year-old female patient who applied with a complaint of a palpable mass under the right areola. The result of biopsy was interpreted morphologically as spindle cell proliferation containing necrosis. Thereafter, the mass was excised with simple mastectomy. The results of the immunohistochemical examination of the tumor with the diameter of 6 cm revealed progesterone receptor, estrogen receptor and HER2 to be negative, p63 staining to be positive. The mass was histopathologically diagnosed as metaplastic carcinoma with well differentiated squamous cell and malignant mesenchymal component (osteosarcomatous area).

Conclusion:

Metaplastic breast carcinoma which resembles invasive ductal carcinoma with general characteristics is differentiated from invasive ductal carcinoma with larger tumor size, less lymph node involvement, less hormone receptor positivity. In order to prevent the delay of diagnosis, invasive ductal carcinoma should be considered in the definitive diagnosis in the elderly patients. Treatment should be started immediately and followed closely because of the high risk of local recurrence.