9例化生性乳腺癌临床病理分析

  目的  化生性乳腺癌(MBC)是一种非常罕见的乳腺癌类型。本研究通过分析化生性乳腺癌的临床特点、病理特征和预后状况，提高对本病的认识。  方法  回顾分析蚌埠医学院第一附属医院2011年1月—2019年10月期间收治的9例化生性乳腺癌患者的临床病例资料，总结其病理特点、治疗方案及预后。  结果  9例患者年龄46~60岁，中位年龄49岁，肿瘤直径1.0~4.5 cm，影像学检查无明显特异性，淋巴结转移者4例；临床分期:Ⅰ期3例，Ⅱ期5例，Ⅲ期1例；9例患者激素受体均阴性，1例患者CerbB-2受体阳性；8例患者行乳腺癌改良根治术，1例行乳腺单纯切除加前哨淋巴结活检术；8例患者接受了术后辅助化疗，其中，TAC方案4例、AT方案1例、PA方案1例、TP方案1例、1例患者因多西他赛过敏改为EC加卡培他滨；2例患者接受了术后放疗；1例患者因年龄及身体等原因未进行术后放化疗。3例复发，1例死亡。  结论  化生性乳腺癌是一种罕见的乳腺癌亚型，无特殊的影像学表现，组织成分复杂多样，激素受体及HER-2多呈阴性，具有不良的生物学行为和预后，目前尚无标准的治疗方案。因此进一步加深对化生性乳腺癌的研究或许能够发现新的、潜在有效的治疗方案，最终改善该类患者的预后。 

Clinicopathological analysis of 9 patients with metaplastic breast carcinoma

  Objective  Metaplastic breast cancinoma (MBC) is a very rare form of breast cancer. This study aimed to analyze the clinicopathologyic features and prognosis of MBC.  Methods  The clinicopathological data of 9 patients with MBC admitted to the First Affiliated Hospital of Bengbu Medical College from January 2011 to October 2019 were retrospectively reviewed, and the pathological characteristics, treatment and prognosis were summarized.  Results  All nine cases were women aged 46-60 years with median age of 49 years. The size of tumor was 1.0 to 4.5 cm, there was no obvious specificity in all imaging examination. Lymph node metastasis was found in 4 cases. Clinical stages: 3 cases of stage Ⅰ, 5 cases of stage Ⅱ and 1 cases of stage Ⅲ. All 9 cases were with negative hormone receptor, and 1 case was with positive for CerbB-2 receptor. The modified radical mastectomy was performed in 8 patients, and the simple breast resection plus sentinel lymph node biopsy was performed in 1 patient. Eight patients received postoperative adjuvant chemotherapy. Among them, there were 4 patients with chemotherapy regimen, 1 patient with AT chemotherapy regimen, 1 patient with PA chemotherapy regimen, 1 patient with TP chemotherapy regiment, 1 patient with E C chemotherapy regime plus capecitabine due to docetaxel allergy. Two patients received postoperative radiotherpy. One patient did not receive postoperative chemoradiotherapy due to age and physical reasons. Three cases had a recurrence, 1 case died from cancer.  Conclusion  The MBC is a rare malignant tumor of breast cancer that dose not has special imaging features, complex and diverse tissue components, negative hormone receptors and CerbB-2, and poor biological behavior and prognosis. Currently, there is no standard treatment plan. Therefore, further research on metastatic breast cancer may lead to the discovery of new and potentially effective treatment regimens, and ultimately improve the prognosis of these patients.