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Oral Metastasis of Metaplastic Breast Carcinoma in a Patient with Neurofibromatosis 1

Identifieur interne : 006705 ( Ncbi/Merge ); précédent : 006704; suivant : 006706

Oral Metastasis of Metaplastic Breast Carcinoma in a Patient with Neurofibromatosis 1

Auteurs : Ana Paula Molina Vivas [Brésil] ; Luana Eschholz Bomfin [Brésil] ; Clovis Antonio Lopes Pinto [Brésil] ; Ulisses Ribaldo Nicolau [Brésil] ; Fabio Abreu Alves [Brésil]

Source :

RBID : PMC:4021739

Abstract

Neurofibromatosis type 1 (NF1) has been associated with an increased risk for development of malignancy, especially malignant peripheral nerve sheath tumors. In addition, recently, literature has demonstrated an increased risk of breast cancer in women with NF1. The present paper shows a 53-year-old woman with NF1 who presented with metaplastic breast carcinoma and developed multiple metastases, including mandible. Furthermore, we reviewed the English literature, found 63 cases showing the association between NF1 and breast cancer, and added one more case. The present study demonstrated an important association between NF1 and breast cancer. Until the present time, there has been only one case of metaplastic breast carcinoma associated with NF1. Curiously, in our case the oral metastasis corresponded to sarcomatous component of metaplastic breast carcinoma.


Url:
DOI: 10.1155/2014/719061
PubMed: 24876981
PubMed Central: 4021739

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PMC:4021739

Le document en format XML

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</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Case Rep Oncol Med</journal-id>
<journal-id journal-id-type="iso-abbrev">Case Rep Oncol Med</journal-id>
<journal-id journal-id-type="publisher-id">CRIONM</journal-id>
<journal-title-group>
<journal-title>Case Reports in Oncological Medicine</journal-title>
</journal-title-group>
<issn pub-type="ppub">2090-6706</issn>
<issn pub-type="epub">2090-6714</issn>
<publisher>
<publisher-name>Hindawi Publishing Corporation</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">24876981</article-id>
<article-id pub-id-type="pmc">4021739</article-id>
<article-id pub-id-type="doi">10.1155/2014/719061</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Case Report</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Oral Metastasis of Metaplastic Breast Carcinoma in a Patient with Neurofibromatosis 1</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Vivas</surname>
<given-names>Ana Paula Molina</given-names>
</name>
<xref ref-type="aff" rid="I1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bomfin</surname>
<given-names>Luana Eschholz</given-names>
</name>
<xref ref-type="aff" rid="I2">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Pinto</surname>
<given-names>Clovis Antonio Lopes</given-names>
</name>
<xref ref-type="aff" rid="I3">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Nicolau</surname>
<given-names>Ulisses Ribaldo</given-names>
</name>
<xref ref-type="aff" rid="I4">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Alves</surname>
<given-names>Fabio Abreu</given-names>
</name>
<xref ref-type="aff" rid="I1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="I2">
<sup>2</sup>
</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
</contrib>
</contrib-group>
<aff id="I1">
<sup>1</sup>
Stomatology Department, A.C. Camargo Cancer Center, Rua Professor Antonio Prudente 211, 01509-900 São Paulo, SP, Brazil</aff>
<aff id="I2">
<sup>2</sup>
Stomatology Department, University of São Paulo, Avenida Professor Lineu Prestes 2227, 05508-000 São Paulo, SP, Brazil</aff>
<aff id="I3">
<sup>3</sup>
Pathology Department, A.C. Camargo Cancer Center, Rua Professor Antonio Prudente 211, 01509-900 São Paulo, SP, Brazil</aff>
<aff id="I4">
<sup>4</sup>
Clinical Oncology Department, A.C. Camargo Cancer Center, Rua Professor Antonio Prudente 211, 01509-900 São Paulo, SP, Brazil</aff>
<author-notes>
<corresp id="cor1">*Fabio Abreu Alves:
<email>falves@accamargo.org.br</email>
</corresp>
<fn fn-type="other">
<p>Academic Editor: Ossama W. Tawfik</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<year>2014</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>4</month>
<year>2014</year>
</pub-date>
<volume>2014</volume>
<elocation-id>719061</elocation-id>
<history>
<date date-type="received">
<day>25</day>
<month>2</month>
<year>2014</year>
</date>
<date date-type="accepted">
<day>9</day>
<month>4</month>
<year>2014</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright © 2014 Ana Paula Molina Vivas et al.</copyright-statement>
<copyright-year>2014</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/3.0/">
<license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract>
<p>Neurofibromatosis type 1 (NF1) has been associated with an increased risk for development of malignancy, especially malignant peripheral nerve sheath tumors. In addition, recently, literature has demonstrated an increased risk of breast cancer in women with NF1. The present paper shows a 53-year-old woman with NF1 who presented with metaplastic breast carcinoma and developed multiple metastases, including mandible. Furthermore, we reviewed the English literature, found 63 cases showing the association between NF1 and breast cancer, and added one more case. The present study demonstrated an important association between NF1 and breast cancer. Until the present time, there has been only one case of metaplastic breast carcinoma associated with NF1. Curiously, in our case the oral metastasis corresponded to sarcomatous component of metaplastic breast carcinoma.</p>
</abstract>
</article-meta>
</front>
<floats-group>
<fig id="fig1" orientation="portrait" position="float">
<label>Figure 1</label>
<caption>
<p>(a) Abdominal surface presenting café au lait macules and multiple cutaneous neurofibromas. (b) Upper member with cutaneous neurofibromas. (c) Intraoral view showing an extensive tumor with necrotic surface located on the left retromolar area.</p>
</caption>
<graphic xlink:href="CRIONM2014-719061.001"></graphic>
</fig>
<fig id="fig2" orientation="portrait" position="float">
<label>Figure 2</label>
<caption>
<p>(a) Histological findings of malignant neoplasia of the oral cavity, showing atypical spindle cells with a storiform arrangement (H&E stain, ×40). (b) Areas with osteoclast-like cells (H&E stain, ×400). (c) Histological findings of metaplastic breast carcinoma with carcinoma
<italic> in situ</italic>
area beside the sarcomatous component (H&E, ×100). (d) Invasive ductal carcinoma (H&E, ×40). (e) Sarcomatoid pattern with hemangiopericytic area (H&E, ×40). (f) Sarcomatoid component with osteoclast-like cells (H&E, ×200).</p>
</caption>
<graphic xlink:href="CRIONM2014-719061.002"></graphic>
</fig>
<fig id="fig3" orientation="portrait" position="float">
<label>Figure 3</label>
<caption>
<p>Immunoreactivity of metaplastic carcinoma. (a) Strong immunoreactivity for vimentin in the sarcomatous component. (b) Immunoreactivity for cytokeratin AE1/AE3 is present in few cells of the sarcomatous component. (c) Reactivity for smooth muscle actin in focal area. (d) Immunoreactivity for CD68 in osteoclast-like cells. (e) Nuclear immunoreactivity for Ki-67. (f) Expression of p53 (polymer-HRP detection system, biotin-free).</p>
</caption>
<graphic xlink:href="CRIONM2014-719061.003"></graphic>
</fig>
<table-wrap id="tab1" orientation="portrait" position="float">
<label>Table 1</label>
<caption>
<p>Immunohistochemical features observed in both carcinoma and sarcomatoid components and in both breast and mandibular tumors.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" rowspan="2" colspan="1">Antibody</th>
<th align="center" rowspan="2" colspan="1">Clone</th>
<th align="center" colspan="2" rowspan="1">Breast Cancer</th>
<th align="center" rowspan="2" colspan="1">Oral metastasis</th>
</tr>
<tr>
<th align="center" rowspan="1" colspan="1">Carcinoma</th>
<th align="center" rowspan="1" colspan="1">Sarcomatous</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">ER</td>
<td align="center" rowspan="1" colspan="1">SP1—DAKO</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">PR</td>
<td align="center" rowspan="1" colspan="1">PgR636—DAKO</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="2" colspan="1">C-erbB-e</td>
<td align="center" rowspan="2" colspan="1">Polyclonal—DAKO</td>
<td align="center" rowspan="1" colspan="1">(1+) invasive carcinoma</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" rowspan="1" colspan="1">(3+) carcinoma
<italic>in situ </italic>
</td>
<td align="center" rowspan="1" colspan="1">(0)</td>
<td align="center" rowspan="1" colspan="1">(0)</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">CK5</td>
<td align="center" rowspan="1" colspan="1">XM26 (mouse)—Neomarkers</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">CK14</td>
<td align="center" rowspan="1" colspan="1">LL002 (mouse)—Thermo Scientific</td>
<td align="center" rowspan="1" colspan="1">+ carcinoma
<italic>in situ </italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="2" colspan="1">CKAE1/AE3</td>
<td align="center" rowspan="2" colspan="1">AE1-AE3—DAKO</td>
<td align="center" rowspan="2" colspan="1">+</td>
<td align="center" rowspan="1" colspan="1">+</td>
<td align="center" rowspan="1" colspan="1">+</td>
</tr>
<tr>
<td align="center" rowspan="1" colspan="1">1% neoplastic cells</td>
<td align="center" rowspan="1" colspan="1">1% neoplastic cells</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="2" colspan="1">p63</td>
<td align="center" rowspan="2" colspan="1">4A4—DAKO</td>
<td align="center" rowspan="2" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">+</td>
<td align="center" rowspan="2" colspan="1"></td>
</tr>
<tr>
<td align="center" rowspan="1" colspan="1">10% neoplastic cells</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="2" colspan="1">p53</td>
<td align="center" rowspan="2" colspan="1">D0-7—DAKO</td>
<td align="center" rowspan="1" colspan="1">+</td>
<td align="center" rowspan="1" colspan="1">+</td>
<td align="center" rowspan="1" colspan="1">+</td>
</tr>
<tr>
<td align="center" rowspan="1" colspan="1">20% neoplastic cells</td>
<td align="center" rowspan="1" colspan="1">40% neoplastic cells</td>
<td align="center" rowspan="1" colspan="1">80% neoplastic cells</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="2" colspan="1">Ki-67</td>
<td align="center" rowspan="2" colspan="1">MIB-1—DAKO</td>
<td align="center" rowspan="1" colspan="1">Proliferative activity</td>
<td align="center" rowspan="1" colspan="1">Proliferative activity</td>
<td align="center" rowspan="1" colspan="1">Proliferative activity</td>
</tr>
<tr>
<td align="center" rowspan="1" colspan="1">50%</td>
<td align="center" rowspan="1" colspan="1">80%</td>
<td align="center" rowspan="1" colspan="1">90%</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Vimentin</td>
<td align="center" rowspan="1" colspan="1">V9—DAKO</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">+</td>
<td align="center" rowspan="1" colspan="1">+</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">SMA</td>
<td align="center" rowspan="1" colspan="1">1A4—DAKO</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">+ focal areas</td>
<td align="center" rowspan="1" colspan="1">+ focal areas</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Desmin</td>
<td align="center" rowspan="1" colspan="1">D33—DAKO</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Myogenin</td>
<td align="center" rowspan="1" colspan="1">F5D—DAKO</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Myo-D1</td>
<td align="center" rowspan="1" colspan="1">5.8A—DAKO</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">S-100</td>
<td align="center" rowspan="1" colspan="1">Polyclonal—DAKO</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">+ focal areas</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">CD68</td>
<td align="center" rowspan="1" colspan="1">KP1—DAKO</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">+ osteoclast-like cells</td>
<td align="center" rowspan="1" colspan="1">+ osteoclast-like cells</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>ER: estrogen receptor; PR: progesterone receptor; CK: cytokeratin; SMA: smooth muscle actin.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tab2" orientation="portrait" position="float">
<label>Table 2</label>
<caption>
<p>Total of patients with NF1 who developed breast carcinoma considering only English language literature.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" rowspan="1" colspan="1">Authors</th>
<th align="center" rowspan="1" colspan="1">
<italic>N</italic>
</th>
<th align="center" rowspan="1" colspan="1">Breast cancer subtype</th>
<th align="center" rowspan="1" colspan="1">Age (years)</th>
<th align="center" rowspan="1" colspan="1">Follow-up (months)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">Brasfield and Das Gupta [
<xref rid="B13" ref-type="bibr">12</xref>
]</td>
<td align="center" rowspan="1" colspan="1">5</td>
<td align="center" rowspan="1" colspan="1">Breast carcinoma*</td>
<td align="center" rowspan="1" colspan="1">1 patient 39, the others not informed</td>
<td align="center" rowspan="1" colspan="1">All dead within 60</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">McMillan and Edwards [
<xref rid="B17" ref-type="bibr">13</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Spheroidal-cell carcinoma</td>
<td align="center" rowspan="1" colspan="1">27</td>
<td align="center" rowspan="1" colspan="1">Dead, 168</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">El-Zawahry et al. [
<xref rid="B18" ref-type="bibr">14</xref>
]</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">Lobular carcinoma
<break></break>
Breast carcinoma*</td>
<td align="center" rowspan="1" colspan="1">40
<break></break>
70</td>
<td align="center" rowspan="1" colspan="1">Not informed</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Zöller et al. [
<xref rid="B19" ref-type="bibr">15</xref>
]</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">Ductal carcinoma
<break></break>
Ductal carcinoma</td>
<td align="center" rowspan="1" colspan="1">38
<break></break>
66</td>
<td align="center" rowspan="1" colspan="1">Dead 36
<break></break>
Dead 24</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Nakamura et al. [
<xref rid="B15" ref-type="bibr">16</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Scirrhous carcinoma</td>
<td align="center" rowspan="1" colspan="1">49</td>
<td align="center" rowspan="1" colspan="1">Dead 5</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Murayama et al. [
<xref rid="B14" ref-type="bibr">17</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Ductal carcinoma</td>
<td align="center" rowspan="1" colspan="1">66</td>
<td align="center" rowspan="1" colspan="1">Alive 8</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Ceccaroni et al. [
<xref rid="B20" ref-type="bibr">18</xref>
]</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">Breast carcinoma* 
<break></break>
Breast carcinoma*</td>
<td align="center" rowspan="1" colspan="1">52
<break></break>
66</td>
<td align="center" rowspan="1" colspan="1">Not informed</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Satgé et al. [
<xref rid="B21" ref-type="bibr">19</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Ductal carcinoma</td>
<td align="center" rowspan="1" colspan="1">23</td>
<td align="center" rowspan="1" colspan="1">Alive 168</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Güran and Safali [
<xref rid="B12" ref-type="bibr">20</xref>
]</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">Ductal carcinoma
<break></break>
Ductal carcinoma</td>
<td align="center" rowspan="1" colspan="1">23
<break></break>
58</td>
<td align="center" rowspan="1" colspan="1">Not informed</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Posada and Chakmakjian [
<xref rid="B22" ref-type="bibr">21</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Lobular carcinoma</td>
<td align="center" rowspan="1" colspan="1">74</td>
<td align="center" rowspan="1" colspan="1">Alive 36</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Walker et al. [
<xref rid="B23" ref-type="bibr">22</xref>
]</td>
<td align="center" rowspan="1" colspan="1">5</td>
<td align="center" rowspan="1" colspan="1">4 ductal carcinoma
<break></break>
1 lobular carcinoma</td>
<td align="center" rowspan="1" colspan="1">Mean age 46.4</td>
<td align="center" rowspan="1" colspan="1">Not informed</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Natsiopoulos et al. [
<xref rid="B11" ref-type="bibr">11</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Metaplastic carcinoma</td>
<td align="center" rowspan="1" colspan="1">60</td>
<td align="center" rowspan="1" colspan="1">Alive 30</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Sharif et al. [
<xref rid="B5" ref-type="bibr">5</xref>
]</td>
<td align="center" rowspan="1" colspan="1">14</td>
<td align="center" rowspan="1" colspan="1">11 ductal carcinoma
<break></break>
3 lobular carcinoma</td>
<td align="center" rowspan="1" colspan="1">Mean age 43.5</td>
<td align="center" rowspan="1" colspan="1">5 died mean 66
<break></break>
3 died other causes
<break></break>
6 alive mean 54</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Hasson et al. [
<xref rid="B24" ref-type="bibr">23</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Ductal carcinoma</td>
<td align="center" rowspan="1" colspan="1">49</td>
<td align="center" rowspan="1" colspan="1">Not informed</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Invernizzi et al. [
<xref rid="B25" ref-type="bibr">24</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Ductal carcinoma</td>
<td align="center" rowspan="1" colspan="1">60</td>
<td align="center" rowspan="1" colspan="1">Alive 36</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Alamsamimi et al. [
<xref rid="B26" ref-type="bibr">25</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Ductal carcinoma</td>
<td align="center" rowspan="1" colspan="1">51</td>
<td align="center" rowspan="1" colspan="1">Alive 24</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Hegyi et al. [
<xref rid="B27" ref-type="bibr">26</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Malignant myoepithelioma</td>
<td align="center" rowspan="1" colspan="1">41</td>
<td align="center" rowspan="1" colspan="1">Not informed</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Salemis et al. [
<xref rid="B16" ref-type="bibr">27</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Ductal carcinoma</td>
<td align="center" rowspan="1" colspan="1">59</td>
<td align="center" rowspan="1" colspan="1">Alive 20</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Bhargava et al. [
<xref rid="B28" ref-type="bibr">28</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Ductal carcinoma</td>
<td align="center" rowspan="1" colspan="1">58</td>
<td align="center" rowspan="1" colspan="1">Alive 13</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Takeuchi et al. [
<xref rid="B29" ref-type="bibr">29</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Ductal and lobular carcinoma</td>
<td align="center" rowspan="1" colspan="1">69</td>
<td align="center" rowspan="1" colspan="1">Alive 6</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Zhou et al. [
<xref rid="B30" ref-type="bibr">30</xref>
]</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Ductal carcinoma</td>
<td align="center" rowspan="1" colspan="1">48</td>
<td align="center" rowspan="1" colspan="1">Alive 8</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Madanikia et al. [
<xref rid="B6" ref-type="bibr">6</xref>
]</td>
<td align="center" rowspan="1" colspan="1">4</td>
<td align="center" rowspan="1" colspan="1">3 ductal carcinoma
<break></break>
1 unknown</td>
<td align="center" rowspan="1" colspan="1">Not informed</td>
<td align="center" rowspan="1" colspan="1">Not informed</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Wang et al. [
<xref rid="B7" ref-type="bibr">7</xref>
]</td>
<td align="center" rowspan="1" colspan="1">11</td>
<td align="center" rowspan="1" colspan="1">10 ductal carcinoma
<break></break>
1 lobular and ductal carcinoma</td>
<td align="center" rowspan="1" colspan="1">Mean age 48.8</td>
<td align="center" rowspan="1" colspan="1">Not informed</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Campos et al. [
<xref rid="B31" ref-type="bibr">31</xref>
]</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">Breast carcinoma* 
<break></break>
Ductal carcinoma</td>
<td align="center" rowspan="1" colspan="1">40
<break></break>
35</td>
<td align="center" rowspan="1" colspan="1">Dead
<break></break>
Alive 24</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Present case</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">Metaplastic carcinoma</td>
<td align="center" rowspan="1" colspan="1">53</td>
<td align="center" rowspan="1" colspan="1">Dead 3</td>
</tr>
<tr>
<td align="left" colspan="5" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Total</td>
<td align="center" rowspan="1" colspan="1">
<bold>64</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>*Subtype not informed.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>Brésil</li>
</country>
<region>
<li>État de São Paulo</li>
</region>
<settlement>
<li>São Paulo</li>
</settlement>
<orgName>
<li>Université de São Paulo</li>
</orgName>
</list>
<tree>
<country name="Brésil">
<region name="État de São Paulo">
<name sortKey="Vivas, Ana Paula Molina" sort="Vivas, Ana Paula Molina" uniqKey="Vivas A" first="Ana Paula Molina" last="Vivas">Ana Paula Molina Vivas</name>
</region>
<name sortKey="Alves, Fabio Abreu" sort="Alves, Fabio Abreu" uniqKey="Alves F" first="Fabio Abreu" last="Alves">Fabio Abreu Alves</name>
<name sortKey="Alves, Fabio Abreu" sort="Alves, Fabio Abreu" uniqKey="Alves F" first="Fabio Abreu" last="Alves">Fabio Abreu Alves</name>
<name sortKey="Bomfin, Luana Eschholz" sort="Bomfin, Luana Eschholz" uniqKey="Bomfin L" first="Luana Eschholz" last="Bomfin">Luana Eschholz Bomfin</name>
<name sortKey="Nicolau, Ulisses Ribaldo" sort="Nicolau, Ulisses Ribaldo" uniqKey="Nicolau U" first="Ulisses Ribaldo" last="Nicolau">Ulisses Ribaldo Nicolau</name>
<name sortKey="Pinto, Clovis Antonio Lopes" sort="Pinto, Clovis Antonio Lopes" uniqKey="Pinto C" first="Clovis Antonio Lopes" last="Pinto">Clovis Antonio Lopes Pinto</name>
</country>
</tree>
</affiliations>
</record>

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