Metaplastic breast cancer treatment

 What is metaplastic breast cancer?

Metaplastic breast cancer is an uncommon type of breast cancer that affects less than 1% of all women. It is distinct from the more frequent types of breast cancer in terms of both its makeup and how it behaves.







When cells in the breast begin to divide and expand abnormally, breast cancer develops. Breast cancer can manifest itself in a variety of ways. Under a microscope, a pathologist (a specialist who studies tissue removed during a biopsy or surgery) examines the cancer cells to determine what form of breast cancer they are based on their appearance.

Metaplastic breast cancer is a type of invasive cancer, meaning it can spread to other regions of the body.

Symptoms of metaplastic breast cancer

Metaplastic breast cancer has the same symptoms as other kinds of breast cancer:

  • An increase or decrease in the size of the breasts
  • A lump in the skin or a thickening of the skin
  • Alterations to the nipple
  • Dimpling or puckering of the skin
  • Breast discomfort

Routine breast screening can often detect cancer before symptoms appear. As a result, some women will be diagnosed with metaplastic breast cancer after having their breasts screened despite having none of the symptoms listed above.

How is metaplastic breast cancer diagnosed?

A variety of assays are used to diagnose metaplastic breast cancer. These may include the following:

  • A mammogram is a test that is used to detect breast cancer (breast x-ray)
  • An ultrasound examination (using sound waves to produce an image)
  • A core biopsy of the breast and lymph nodes (using a hollow needle to take a sample of tissue to be examined under a microscope – numerous tissue samples may be taken at the same time) is a procedure that involves taking a sample of tissue and examining it under a microscope.
  • A fine needle aspiration (FNA) of the breast and/or lymph nodes (using a fine needle and syringe to collect a sample of cells to be examined under a microscope) is a procedure that involves taking a sample of cells from the breast and/or lymph nodes.

What treatment options are available for metaplastic breast cancer?

The treatments you receive will be determined by the characteristics of your metaplastic breast cancer, as with all types of breast cancer (such as size, grade, hormone receptor status and HER2 status).

The term “triple negative” refers to breast tumors that are negative for HER2, oestrogen receptor, and progesterone receptor.Because metaplastic breast cancer is more likely to be triple negative, your treatment options will be limited. Learn more about breast cancer that is triple negative.



Surgery

When it comes to metaplastic breast cancer, surgery is frequently the initial therapeutic option. If your cancer is triple negative, you may need to start with chemotherapy. This is referred to as neo-adjuvant or main therapy.

It’s possible that the surgery you’re having is:

  • Breast-conserving surgery, also known as wide local excision or lumpectomy, involves removing the malignancy while leaving a margin (border) of healthy breast tissue.
  • Mastectomy is the surgical removal of all breast tissue, including the nipple area.

The amount of tissue removed is determined by the affected area of the breast, the size of the cancer in relation to the size of your breast, and whether the cancer has spread to more than one area of the breast. This will be discussed with you by your breast surgeon.

It’s critical to have a clear margin of tissue removed from around the tumour if you’re having breast-conserving surgery.A second operation may be required if a distinct margin of tissue is not visible when the region removed is viewed under a microscope.

You may be able to get breast reconstruction either at the same time as your mastectomy (immediate reconstruction) or at a later period if you’re having a mastectomy (delayed reconstruction).

Many women who have had a mastectomy but not had their breasts rebuilt choose to use a prosthesis, which is an artificial breast form that fits inside a bra.

After a mastectomy, some women prefer not to have reconstruction or use a prosthetic.

 

Lymph node removal

Other invasive breast cancers are less likely than metaplastic breast cancer to spread to the lymph nodes (glands) under the arm (axilla). Your medical staff, on the other hand, will want to see if your lymph nodes contain cancer cells. This, coupled with other facts about your breast cancer, aids them in determining whether you may benefit from extra therapy following the surge.To accomplish this, your surgeon is likely to recommend removing some or all of the lymph nodes (through a lymph node sample or biopsy) (a lymph node clearance).

Biopsy of a sentinel lymph node

If examinations prior to surgery reveal no signs of cancer cells in the lymph nodes, a sentinel lymph node biopsy is commonly used. It determines if the sentinel lymph node (the first lymph node where cancer cells are most likely to spread) is cancer-free. There could be many sentinel lymph nodes. If it’s clear, it’s likely that the other nodes are as well, so no more need to be removed.

Sentinel lymph node biopsy is commonly done at the same time as cancer surgery, but it can also be done separately.

More surgery or radiotherapy to the remaining lymph nodes may be advised if the results of the sentinel lymph node biopsy demonstrate that the first node or nodes are impacted.

If tests performed prior to surgery reveal that your lymph nodes contain cancer cells, a sentinel lymph node biopsy is not recommended. In this instance, your surgeon is likely to prescribe lymph node clearance.

Therapies that are used as adjuvants (additional treatments)

Other therapies may be required after surgery. These are known as adjuvant therapy, and they can include things like:

  • Chemotherapy
  • Radiotherapy
  • Endocrine (hormone) therapy
  • Biological (targeted) therapy
  • Bisphosphonates

The goal of these treatments is to lower the chances of breast cancer recurring in the same breast, growing in the other breast, or spreading to another part of the body.

Some of these treatments are administered prior to the procedure. This is referred to as neo-adjuvant or main therapy.

 

Chemotherapy

Many people with metaplastic breast cancer will be prescribed chemotherapy. Chemotherapy is a treatment that uses anti-cancer medications to kill cancer cells and reduces the risk of breast cancer returning or spreading.

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Whether or not you are administered chemotherapy is determined by a number of factors, including the cancer’s size, grade, hormone receptor status, HER2 status, and whether or not lymph nodes are involved.

Chemotherapy may be given before or after surgery.

Radiotherapy

If you have breast-conserving surgery, you will most likely be prescribed breast radiation to lower the risk of cancer returning in the same breast.

Radiotherapy to the lymph nodes beneath the arm or above the collarbone may also be used in some cases.

After a mastectomy, radiotherapy is sometimes delivered to the chest wall, for example, if some lymph nodes beneath the arm are enlarged.

Endocrine (hormone) therapy

Oestrogen in the body aids the growth of some breast cancers. Breast cancers that are oestrogen receptor positive (ER+) are referred to as ER+.

Hormone therapies reduce or eliminate oestrogen’s influence on breast cancer cells. Different hormone treatment medicines work in different ways to accomplish this.

If your breast cancer is ER+, hormone therapy will be recommended.

ER+ breast cancers are examined using tissue from a biopsy or after surgery to see if they are invasive. If your cancer is ER+, your specialist will talk to you about which hormone therapy is best for you.

If oestrogen does not drive your breast cancer, it is called oestrogen receptor negative (ER-), and hormone therapy will not help. Breast cancer that has progressed to the stage of metaplastic disease is more difficult to treat.

Your breast cancer will also be tested to discover if it is progesterone receptor positive (PR+). Another hormone is progesterone. For persons whose breast cancer is exclusively progesterone receptor positive (PR+ and ER-), the benefits of hormone therapy are less evident. Only a small percentage of breast cancers fall into this category. If this is the case, your doctor will talk to you about whether hormone therapy is right for you.

Biological (targeted) therapy

This is a class of medications that stop cancer from spreading and growing. They go for the processes in the cells that aid cancer growth and interfere with them.

The type of targeted therapy you receive will be determined by your breast cancer’s characteristics.

For HER2 positive breast cancer, targeted treatments are the most extensively employed. HER2 is a protein that aids cancer cells in their growth.



HER2 levels can be measured using a variety of procedures performed on breast tissue obtained after a biopsy or surgery. This form of treatment will only benefit those whose cancer has high levels of HER2 (HER2 positive).

If your breast cancer is HER2 negative, targeted therapy for HER2 positive breast cancer will be ineffective. HER2 negative metaplastic breast cancer is common.

Bisphosphonates

Bisphosphonates are a class of medications that can help postmenopausal women prevent breast cancer from spreading. They can be utilized whether you went through menopause naturally or as a result of breast cancer therapy.

Bisphosphonates can also help to prevent or halt the deterioration of bones. They’re frequently given to those who have or are at risk of osteoporosis (a disease in which bones lose their density).

Bisphosphonates can also help to prevent or halt the deterioration of bones. They’re frequently prescribed to patients who have or are at risk of developing osteoporosis (when bones lose their strength and become more likely to break).

Bisphosphonates can be taken orally or intravenously (intravenously).

If bisphosphonates are right for you, your treatment team can tell you.

Follow-up after treatment

After your hospital-based treatments (such as surgery, chemotherapy, or radiotherapy) are completed, you will continue to be monitored. This is referred to as follow-up.

It’s crucial to be aware of any changes to the breast, chest, or surrounding area, whether you undergone breast-conserving surgery or a mastectomy (with or without reconstruction).

Knowing how your breast or scar should feel can be tough. It’s possible that the region surrounding the scar will feel lumpy, numb, or sensitive. This means you’ll have to become used to how it looks and feels so you can figure out what’s normal for you. This will give you more confidence in recognizing changes and reporting them to your GP or breast care nurse as soon as possible. A person who has had breast cancer in one breast has a slightly increased risk of having cancer in the other breast (a new primary breast cancer) than someone who has never had breast cancer. As a result, it’s critical to be aware of any new changes in the other breast and to report them as soon as they occur.

Conclusion

There is no “standard” therapy for all patients with MBC due to its rarity and heterogeneity. Breast conservation therapy is appropriate for a restricted number of patients, and surgical treatment and axillary staging are similar to IDC. Traditional IDC chemo- and hormonal therapy are unsuccessful against MBC and are generally linked to lower survival, whereas histology-specific new chemotherapeutic methods may provide a survival advantage. Targeted medicines based on customized gene profiling are not widely used, despite their potential. Finally, regardless of the type of surgery, adjuvant radiation should be considered as part of multimodality therapy for patients with MBC. Clinical trials evaluating typical therapy for IDC in patients with MBC are needed, but due to the disease’s rarity, they are unlikely to be completed.

Metaplastic breast cancer treatment

Metaplastic breast cancer treatment

Metaplastic breast cancer treatment