Carcinosarcoma of the breast: two case reports and review of the literature
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Auteurs : Kristi M. Esses [États-Unis] ; Ramona M. Hagmaier [États-Unis] ; Susan A. Blanchard [États-Unis] ; John J. Lazarchick [États-Unis] ; Adam I. Riker [États-Unis]Source :
- Cases Journal [ 1757-1626 ] ; 2009.
Abstract
Carcinosarcoma of the breast, often referred to as metaplastic carcinoma of the breast, is a rare malignancy with two distinct cell lines described as a breast carcinoma of ductal type with a sarcoma-like component. Clinically, carcinosarcoma of the breast is an aggressive breast cancer. The prognosis for carcinosarcoma of the breast is less favorable compared to more common types of breast cancer such as infiltrating ductal or lobular carcinoma. Currently, the evaluation of breast carcinoma includes hormone receptor analysis of the tumor tissue, with those positive for estrogen or progesterone responding better to both hormonal and chemotherapy.
Trastuzumab (Herceptin®) is available as an adjunct treatment for tumors which over-express the HER2/neu gene. Typically, metaplastic carcinomas of the breast do not express the estrogen or progesterone receptors and do not over-express the HER2/neu oncogene. As a result of this "triple negative" phenotype, such tumors tend to be more aggressive and are unlikely to respond to targeted therapy with Herceptin. The epidermal growth factor receptor HER-1/EGFR protein is expressed in the majority of metaplastic carcinomas and thus may serve as a potential therapeutic target for EGFR inhibitors such as gefitinib and cetuximab. The two cases we describe exemplify the aggressive nature of carcinosarcoma of the breast and support the findings that this tumor type does not express the common receptors found in other breast carcinomas. These case reports also emphasize the need for investigating the role for blockade of the HER-1/EGFR receptor with targeted therapies when found to be over-expressed in the primary tumor.
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DOI: 10.1186/1757-1626-2-15
PubMed: 19126225
PubMed Central: 2627815
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Hagmaier</name><affiliation wicri:level="1"><nlm:aff id="I2">Mitchell Cancer Institute-University of South Alabama, 1660 Springhill Avenue, Mobile, Alabama 36604, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Mitchell Cancer Institute-University of South Alabama, 1660 Springhill Avenue, Mobile, Alabama 36604</wicri:regionArea></affiliation></author><author><name sortKey="Blanchard, Susan A" sort="Blanchard, Susan A" uniqKey="Blanchard S" first="Susan A" last="Blanchard">Susan A. Blanchard</name><affiliation wicri:level="1"><nlm:aff id="I3">Diagnostic and Medical Center, 1700 Springhill Avenue, Alabama 36604, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Diagnostic and Medical Center, 1700 Springhill Avenue, Alabama 36604</wicri:regionArea></affiliation></author><author><name sortKey="Lazarchick, John J" sort="Lazarchick, John J" uniqKey="Lazarchick J" first="John J" last="Lazarchick">John J. 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Esses</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Pathology, University of South Alabama Medical Center, Mobile, Alabama 36617-2293, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology, University of South Alabama Medical Center, Mobile, Alabama 36617-2293</wicri:regionArea></affiliation></author><author><name sortKey="Hagmaier, Ramona M" sort="Hagmaier, Ramona M" uniqKey="Hagmaier R" first="Ramona M" last="Hagmaier">Ramona M. Hagmaier</name><affiliation wicri:level="1"><nlm:aff id="I2">Mitchell Cancer Institute-University of South Alabama, 1660 Springhill Avenue, Mobile, Alabama 36604, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Mitchell Cancer Institute-University of South Alabama, 1660 Springhill Avenue, Mobile, Alabama 36604</wicri:regionArea></affiliation></author><author><name sortKey="Blanchard, Susan A" sort="Blanchard, Susan A" uniqKey="Blanchard S" first="Susan A" last="Blanchard">Susan A. Blanchard</name><affiliation wicri:level="1"><nlm:aff id="I3">Diagnostic and Medical Center, 1700 Springhill Avenue, Alabama 36604, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Diagnostic and Medical Center, 1700 Springhill Avenue, Alabama 36604</wicri:regionArea></affiliation></author><author><name sortKey="Lazarchick, John J" sort="Lazarchick, John J" uniqKey="Lazarchick J" first="John J" last="Lazarchick">John J. Lazarchick</name><affiliation wicri:level="1"><nlm:aff id="I4">Gulf Regional Pathologists, Mobile Infirmary Medical Center, Mobile, Alabama, 36607, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Gulf Regional Pathologists, Mobile Infirmary Medical Center, Mobile, Alabama, 36607</wicri:regionArea></affiliation></author><author><name sortKey="Riker, Adam I" sort="Riker, Adam I" uniqKey="Riker A" first="Adam I" last="Riker">Adam I. Riker</name><affiliation wicri:level="1"><nlm:aff id="I2">Mitchell Cancer Institute-University of South Alabama, 1660 Springhill Avenue, Mobile, Alabama 36604, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Mitchell Cancer Institute-University of South Alabama, 1660 Springhill Avenue, Mobile, Alabama 36604</wicri:regionArea></affiliation></author></analytic><series><title level="j">Cases Journal</title><idno type="eISSN">1757-1626</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Carcinosarcoma of the breast, often referred to as metaplastic carcinoma of the breast, is a rare malignancy with two distinct cell lines described as a breast carcinoma of ductal type with a sarcoma-like component. Clinically, carcinosarcoma of the breast is an aggressive breast cancer. The prognosis for carcinosarcoma of the breast is less favorable compared to more common types of breast cancer such as infiltrating ductal or lobular carcinoma. Currently, the evaluation of breast carcinoma includes hormone receptor analysis of the tumor tissue, with those positive for estrogen or progesterone responding better to both hormonal and chemotherapy.</p><p>Trastuzumab (Herceptin<sup>®</sup>) is available as an adjunct treatment for tumors which over-express the HER2/neu gene. Typically, metaplastic carcinomas of the breast do not express the estrogen or progesterone receptors and do not over-express the HER2/neu oncogene. As a result of this "triple negative" phenotype, such tumors tend to be more aggressive and are unlikely to respond to targeted therapy with Herceptin. The epidermal growth factor receptor HER-1/EGFR protein is expressed in the majority of metaplastic carcinomas and thus may serve as a potential therapeutic target for EGFR inhibitors such as gefitinib and cetuximab. The two cases we describe exemplify the aggressive nature of carcinosarcoma of the breast and support the findings that this tumor type does not express the common receptors found in other breast carcinomas. These case reports also emphasize the need for investigating the role for blockade of the HER-1/EGFR receptor with targeted therapies when found to be over-expressed in the primary tumor.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Gutman, H" uniqKey="Gutman H">H Gutman</name></author><author><name sortKey="Pollock, Re" uniqKey="Pollock R">RE Pollock</name></author><author><name sortKey="Janjan, Na" uniqKey="Janjan N">NA Janjan</name></author><author><name sortKey="Johnson, Da" uniqKey="Johnson D">DA Johnson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Foschini, Mp" uniqKey="Foschini M">MP Foschini</name></author><author><name sortKey="Dina, Re" uniqKey="Dina R">RE Dina</name></author><author><name sortKey="Eusebi, V" uniqKey="Eusebi V">V Eusebi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosai, J" uniqKey="Rosai J">J Rosai</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wargotz, Es" uniqKey="Wargotz E">ES Wargotz</name></author><author><name sortKey="Norris, Hj" uniqKey="Norris H">HJ Norris</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wargotz, Es" uniqKey="Wargotz E">ES Wargotz</name></author><author><name sortKey="Norris, Hj" uniqKey="Norris H">HJ Norris</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosen" uniqKey="Rosen">Rosen</name></author><author><name sortKey="Peter, Paul" uniqKey="Peter P">Paul Peter</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Beatty, Jd" uniqKey="Beatty J">JD Beatty</name></author><author><name sortKey="Atwood, M" uniqKey="Atwood M">M Atwood</name></author><author><name sortKey="Tickman, R" uniqKey="Tickman R">R Tickman</name></author><author><name sortKey="Reiner, M" uniqKey="Reiner M">M Reiner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tse, Gm" uniqKey="Tse G">GM Tse</name></author><author><name sortKey="Tan, Ph" uniqKey="Tan P">PH Tan</name></author><author><name sortKey="Putti, Tc" uniqKey="Putti T">TC Putti</name></author><author><name sortKey="Lui, Pcw" uniqKey="Lui P">PCW Lui</name></author><author><name sortKey="Chaiwun, B" uniqKey="Chaiwun B">B Chaiwun</name></author><author><name sortKey="Law, Bkb" uniqKey="Law B">BKB Law</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hennessy, Bt" uniqKey="Hennessy B">BT Hennessy</name></author><author><name sortKey="Giordano, S" uniqKey="Giordano S">S Giordano</name></author><author><name sortKey="Broglio, K" uniqKey="Broglio K">K Broglio</name></author><author><name sortKey="Duan, Z" uniqKey="Duan Z">Z Duan</name></author><author><name sortKey="Trent, J" uniqKey="Trent J">J Trent</name></author><author><name sortKey="Buchholz" uniqKey="Buchholz">Buchholz</name></author><author><name sortKey="Babiera, G" uniqKey="Babiera G">G Babiera</name></author><author><name sortKey="Hortobagyi, Gn" uniqKey="Hortobagyi G">GN Hortobagyi</name></author><author><name sortKey="Valero, V" uniqKey="Valero V">V Valero</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tokudome, N" uniqKey="Tokudome N">N Tokudome</name></author><author><name sortKey="Sakamoto, G" uniqKey="Sakamoto G">G Sakamoto</name></author><author><name sortKey="Sakai, T" uniqKey="Sakai T">T Sakai</name></author><author><name sortKey="Sarumaru, S" uniqKey="Sarumaru S">S Sarumaru</name></author><author><name sortKey="Okuyama, N" uniqKey="Okuyama N">N Okuyama</name></author><author><name sortKey="Hori, F" uniqKey="Hori F">F Hori</name></author><author><name sortKey="Horii, R" uniqKey="Horii R">R Horii</name></author><author><name sortKey="Akiyama, F" uniqKey="Akiyama F">F Akiyama</name></author><author><name sortKey="Tanabe, M" uniqKey="Tanabe M">M Tanabe</name></author><author><name sortKey="Saito, K" uniqKey="Saito K">K Saito</name></author><author><name sortKey="Takahashi, K" uniqKey="Takahashi K">K Takahashi</name></author><author><name sortKey="Kasumi, F" uniqKey="Kasumi F">F Kasumi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Leibl, S" uniqKey="Leibl S">S Leibl</name></author><author><name sortKey="Moinfar, F" uniqKey="Moinfar F">F Moinfar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Okumo, S" uniqKey="Okumo S">S Okumo</name></author><author><name sortKey="Kurebayashi, J" uniqKey="Kurebayashi J">J Kurebayashi</name></author><author><name sortKey="Otsuki, T" uniqKey="Otsuki T">T Otsuki</name></author><author><name sortKey="Yamamoto, Y" uniqKey="Yamamoto Y">Y Yamamoto</name></author><author><name sortKey="Tanaka, K" uniqKey="Tanaka K">K Tanaka</name></author><author><name sortKey="Sonoo, H" uniqKey="Sonoo H">H 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Cases J</journal-id><journal-title-group><journal-title>Cases Journal</journal-title></journal-title-group><issn pub-type="epub">1757-1626</issn><publisher><publisher-name>BioMed Central</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">19126225</article-id><article-id pub-id-type="pmc">2627815</article-id><article-id pub-id-type="publisher-id">1757-1626-2-15</article-id><article-id pub-id-type="doi">10.1186/1757-1626-2-15</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>Carcinosarcoma of the breast: two case reports and review of the literature</article-title></title-group><contrib-group><contrib contrib-type="author" id="A1"><name><surname>Esses</surname><given-names>Kristi M</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>kesses@usouthal.edu</email></contrib><contrib contrib-type="author" id="A2"><name><surname>Hagmaier</surname><given-names>Ramona M</given-names></name><xref ref-type="aff" rid="I2">2</xref><email>hagmaier@usouthal.edu</email></contrib><contrib contrib-type="author" id="A3"><name><surname>Blanchard</surname><given-names>Susan A</given-names></name><xref ref-type="aff" rid="I3">3</xref><email>sablanchard@bellsouth.net</email></contrib><contrib contrib-type="author" id="A4"><name><surname>Lazarchick</surname><given-names>John J</given-names></name><xref ref-type="aff" rid="I4">4</xref><email>lazarjjl@yahoo.com</email></contrib><contrib contrib-type="author" corresp="yes" id="A5"><name><surname>Riker</surname><given-names>Adam I</given-names></name><xref ref-type="aff" rid="I2">2</xref><email>ariker@usouthal.edu</email></contrib></contrib-group><aff id="I1"><label>1</label>Department of Pathology, University of South Alabama Medical Center, Mobile, Alabama 36617-2293, USA</aff><aff id="I2"><label>2</label>Mitchell Cancer Institute-University of South Alabama, 1660 Springhill Avenue, Mobile, Alabama 36604, USA</aff><aff id="I3"><label>3</label>Diagnostic and Medical Center, 1700 Springhill Avenue, Alabama 36604, USA</aff><aff id="I4"><label>4</label>Gulf Regional Pathologists, Mobile Infirmary Medical Center, Mobile, Alabama, 36607, USA</aff><pub-date pub-type="collection"><year>2009</year></pub-date><pub-date pub-type="epub"><day>6</day><month>1</month><year>2009</year></pub-date><volume>2</volume><fpage>15</fpage><lpage>15</lpage><history><date date-type="received"><day>2</day><month>12</month><year>2008</year></date><date date-type="accepted"><day>6</day><month>1</month><year>2009</year></date></history><permissions><copyright-statement>Copyright ©2009 Esses et al; licensee BioMed Central Ltd.</copyright-statement><copyright-year>2009</copyright-year><copyright-holder>Esses et al; licensee BioMed Central Ltd.</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><self-uri xlink:href="http://www.casesjournal.com/content/2/1/15"></self-uri><abstract><p>Carcinosarcoma of the breast, often referred to as metaplastic carcinoma of the breast, is a rare malignancy with two distinct cell lines described as a breast carcinoma of ductal type with a sarcoma-like component. Clinically, carcinosarcoma of the breast is an aggressive breast cancer. The prognosis for carcinosarcoma of the breast is less favorable compared to more common types of breast cancer such as infiltrating ductal or lobular carcinoma. Currently, the evaluation of breast carcinoma includes hormone receptor analysis of the tumor tissue, with those positive for estrogen or progesterone responding better to both hormonal and chemotherapy.</p><p>Trastuzumab (Herceptin<sup>®</sup>) is available as an adjunct treatment for tumors which over-express the HER2/neu gene. Typically, metaplastic carcinomas of the breast do not express the estrogen or progesterone receptors and do not over-express the HER2/neu oncogene. As a result of this "triple negative" phenotype, such tumors tend to be more aggressive and are unlikely to respond to targeted therapy with Herceptin. The epidermal growth factor receptor HER-1/EGFR protein is expressed in the majority of metaplastic carcinomas and thus may serve as a potential therapeutic target for EGFR inhibitors such as gefitinib and cetuximab. The two cases we describe exemplify the aggressive nature of carcinosarcoma of the breast and support the findings that this tumor type does not express the common receptors found in other breast carcinomas. These case reports also emphasize the need for investigating the role for blockade of the HER-1/EGFR receptor with targeted therapies when found to be over-expressed in the primary tumor.</p></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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