Recurrence

Is it possible for there to be a recurrence of metaplastic carcinoma in reconstructed breast tissue?  I am going to have a double reconstruction done after my chemotherapy regimen is complete and everything looks fine.

Also, where can I find more information about metaplastic carcinoma because I am getting conflicting information about the recurrence rate and survivability of metaplastic carcinoma (w/node involvement)?

Thank you.

[Cleveland Clinic]

Dear pedinurse:  Metaplastic breast cancer is a very rare form of breast cancer.  These cancers can behave more aggressively.  Recurrences of any cancer can technically occur anywhere though there are sites that might be more common.  I have attached an abstract from medline in an attempt to answer your last question.

Am Surg. 2005 Sep;71(9):725-30.

Metaplastic breast cancer: clinical features and outcomes.

Gibson GR, Qian D, Ku JK, Lai LL.

Department of General Oncologic Surgery, City of Hope National Medical Center, 1500 East Duarte Rd., Duarte, CA 91010, USA.

Metaplastic carcinoma of the breast, a neoplasm with both epithelial and mesenchymal elements, represents less than 1 per cent of all breast cancer. We reviewed the records of all patients diagnosed with localized metaplastic breast cancer from 1991 to 2003 at our institution. We identified 21 patients. Mean primary tumor size was 4.62 cm. Eight patients (38%) had axillary node involvement at presentation. All the tumors were high grade. Only two (10%) of the tumors were hormone receptor positive. Seventeen (81%) of the patients received adjuvant chemotherapy, and 12 (57%) of the patients received radiation. Ten (29%) patients suffered a local recurrence. With a mean follow-up of 46 months, the 5-year disease-free and overall survival was 42 per cent (95% CI: 20% to 65%) and 71 per cent (95% CI: 46% to 96%), respectively. Stage-specific overall survival was 100 per cent, 83 per cent, and 53 per cent for stages I, II, and III, respectively. By multivariate analysis, there was no impact on recurrence or survival with regard to size, age, menopausal status, nodal status, histologic subtype, adjuvant therapy, or extent of surgery. Metaplastic breast cancer is a unique neoplasm that tends to present at an advanced stage and has a propensity for local recurrence. When stratified by stage, however, survival appears similar to that of adenocarcinoma of the breast, and these tumors should be treated as such.

PMID: 16468506 [PubMed - indexed for MEDLINE]