Metaplastic breast tumors with a dominant fibromatosis-like phenotype have a high risk of local recurrence

Helenice Gobbi, Jean F. Simpson, Alexander D Borowsky, Roy A. Jensen, David L. Page

Research output: Contribution to journalArticle

116 Citations (Scopus)

Abstract

BACKGROUND. In the current study the authors describe the clinicopathologic characteristics of a low grade variant of spindle cell metaplastic tumors of the breast. Previously these tumors have been considered within a larger group recognized as metaplastic carcinoma, including cases with higher grade features. METHODS. Breast tumors comprised predominantly of low grade spindle cells, with sparse low grade epithelial elements, were selected. Clinical features as well as macroscopic, microscopic, and immunohistochemical findings were reviewed with emphasis on the biologic behavior and the differential diagnosis from other spindle cell lesions. RESULTS. Of 30 tumors fulfilling strict criteria, 20 contained squamous or glandular elements associated with the spindle cells. Ten tumors were comprised entirely of low grade spindle cells with limited clustered epithelioid cells. At the periphery all tumors showed a proliferation of bland spindle cells infiltrating the adjacent parenchyma and mimicking fibromatosis. The epithelioid cells and some spindle cells expressed both vimentin and one or more cytokeratins. Seven of eight patients treated by excisional biopsy developed local recurrence, whereas only one of ten patients treated with wide excisional biopsy developed a local recurrence. No distant or regional metastases occurred. CONCLUSIONS. The presence of limited clusters of epithelioid cells along with a dominant fibromatosis-like pattern may be unique in the breast. The biologic potential of the fibromatosis- like, spindle cell, metaplastic breast tumors most likely is defined by their major histologic phenotype; they are capable of local recurrence with no demonstrated distant spread or regional metastases, as in pure fibromatosis of the breast.

Original languageEnglish (US)
Pages (from-to)2170-2182
Number of pages13
JournalCancer
Volume85
Issue number10
DOIs
StatePublished - May 15 1999
Externally publishedYes

Fingerprint

Fibroma
Breast Neoplasms
Phenotype
Recurrence
Epithelioid Cells
Neoplasms
Breast
Neoplasm Metastasis
Biopsy
Vimentin
Keratins
Differential Diagnosis
Carcinoma

Keywords

  • Breast neoplasms
  • Diagnosis
  • Fibromatosis
  • Immunohistochemical study
  • Metaplastic carcinoma
  • Prognosis
  • Spindle cell carcinoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Metaplastic breast tumors with a dominant fibromatosis-like phenotype have a high risk of local recurrence. / Gobbi, Helenice; Simpson, Jean F.; Borowsky, Alexander D; Jensen, Roy A.; Page, David L.

In: Cancer, Vol. 85, No. 10, 15.05.1999, p. 2170-2182.

Research output: Contribution to journalArticle

Gobbi, Helenice ; Simpson, Jean F. ; Borowsky, Alexander D ; Jensen, Roy A. ; Page, David L. / Metaplastic breast tumors with a dominant fibromatosis-like phenotype have a high risk of local recurrence. In: Cancer. 1999 ; Vol. 85, No. 10. pp. 2170-2182.
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abstract = "BACKGROUND. In the current study the authors describe the clinicopathologic characteristics of a low grade variant of spindle cell metaplastic tumors of the breast. Previously these tumors have been considered within a larger group recognized as metaplastic carcinoma, including cases with higher grade features. METHODS. Breast tumors comprised predominantly of low grade spindle cells, with sparse low grade epithelial elements, were selected. Clinical features as well as macroscopic, microscopic, and immunohistochemical findings were reviewed with emphasis on the biologic behavior and the differential diagnosis from other spindle cell lesions. RESULTS. Of 30 tumors fulfilling strict criteria, 20 contained squamous or glandular elements associated with the spindle cells. Ten tumors were comprised entirely of low grade spindle cells with limited clustered epithelioid cells. At the periphery all tumors showed a proliferation of bland spindle cells infiltrating the adjacent parenchyma and mimicking fibromatosis. The epithelioid cells and some spindle cells expressed both vimentin and one or more cytokeratins. Seven of eight patients treated by excisional biopsy developed local recurrence, whereas only one of ten patients treated with wide excisional biopsy developed a local recurrence. No distant or regional metastases occurred. CONCLUSIONS. The presence of limited clusters of epithelioid cells along with a dominant fibromatosis-like pattern may be unique in the breast. The biologic potential of the fibromatosis- like, spindle cell, metaplastic breast tumors most likely is defined by their major histologic phenotype; they are capable of local recurrence with no demonstrated distant spread or regional metastases, as in pure fibromatosis of the breast.",
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AU - Page, David L.

PY - 1999/5/15

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N2 - BACKGROUND. In the current study the authors describe the clinicopathologic characteristics of a low grade variant of spindle cell metaplastic tumors of the breast. Previously these tumors have been considered within a larger group recognized as metaplastic carcinoma, including cases with higher grade features. METHODS. Breast tumors comprised predominantly of low grade spindle cells, with sparse low grade epithelial elements, were selected. Clinical features as well as macroscopic, microscopic, and immunohistochemical findings were reviewed with emphasis on the biologic behavior and the differential diagnosis from other spindle cell lesions. RESULTS. Of 30 tumors fulfilling strict criteria, 20 contained squamous or glandular elements associated with the spindle cells. Ten tumors were comprised entirely of low grade spindle cells with limited clustered epithelioid cells. At the periphery all tumors showed a proliferation of bland spindle cells infiltrating the adjacent parenchyma and mimicking fibromatosis. The epithelioid cells and some spindle cells expressed both vimentin and one or more cytokeratins. Seven of eight patients treated by excisional biopsy developed local recurrence, whereas only one of ten patients treated with wide excisional biopsy developed a local recurrence. No distant or regional metastases occurred. CONCLUSIONS. The presence of limited clusters of epithelioid cells along with a dominant fibromatosis-like pattern may be unique in the breast. The biologic potential of the fibromatosis- like, spindle cell, metaplastic breast tumors most likely is defined by their major histologic phenotype; they are capable of local recurrence with no demonstrated distant spread or regional metastases, as in pure fibromatosis of the breast.

AB - BACKGROUND. In the current study the authors describe the clinicopathologic characteristics of a low grade variant of spindle cell metaplastic tumors of the breast. Previously these tumors have been considered within a larger group recognized as metaplastic carcinoma, including cases with higher grade features. METHODS. Breast tumors comprised predominantly of low grade spindle cells, with sparse low grade epithelial elements, were selected. Clinical features as well as macroscopic, microscopic, and immunohistochemical findings were reviewed with emphasis on the biologic behavior and the differential diagnosis from other spindle cell lesions. RESULTS. Of 30 tumors fulfilling strict criteria, 20 contained squamous or glandular elements associated with the spindle cells. Ten tumors were comprised entirely of low grade spindle cells with limited clustered epithelioid cells. At the periphery all tumors showed a proliferation of bland spindle cells infiltrating the adjacent parenchyma and mimicking fibromatosis. The epithelioid cells and some spindle cells expressed both vimentin and one or more cytokeratins. Seven of eight patients treated by excisional biopsy developed local recurrence, whereas only one of ten patients treated with wide excisional biopsy developed a local recurrence. No distant or regional metastases occurred. CONCLUSIONS. The presence of limited clusters of epithelioid cells along with a dominant fibromatosis-like pattern may be unique in the breast. The biologic potential of the fibromatosis- like, spindle cell, metaplastic breast tumors most likely is defined by their major histologic phenotype; they are capable of local recurrence with no demonstrated distant spread or regional metastases, as in pure fibromatosis of the breast.

KW - Breast neoplasms

KW - Diagnosis

KW - Fibromatosis

KW - Immunohistochemical study

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