Metaplastic breast cancer (MBC) is a rare and aggressive form of breast cancer. It typically presents as a fast-growing lump or mass within the breast.
In imaging examinations, the tumour can resemble an invasive ductal carcinoma, which is a common breast cancer that begins in the milk ducts and spreads to surrounding tissue. However, metaplastic breast cancer tumours are often larger at the point of diagnosis.
Under microscopic analysis, MBC cells display a mix of different cancer cell types. While it was once thought to originate from two separate cancers merging, current evidence suggests that metaplastic breast cancer is a single cancer that may begin in very young cells with the potential to develop into various mature cell types.
Compared to other types of breast cancer, metaplastic breast cancer grows faster and is more likely to spread (metastasise) to other parts of the body. There is also a higher likelihood of the cancer recurring after initial successful treatment.
The five-year survival rate for patients with metaplastic breast cancer is approximately 55%. This figure does not account for recent advancements in treatment, meaning the current survival rate may be higher due to newer, more effective therapies.
Breast cancer symptoms can vary between individuals, and no two lumps or masses feel exactly alike. We recommend familiarising yourself with the normal look and feel of your breasts, and reporting any changes to your doctor. It is important to note that many breast cancers are detected through routine screening mammograms before any symptoms even appear.
These symptoms do not automatically confirm a breast cancer diagnosis. However, it is essential to discuss any new or concerning symptoms with your doctor, as they may also indicate other underlying health problems. Genetic counselling may be appropriate for you and your family to understand inherited risks.
If you notice changes in your breasts, experience symptoms, or receive an abnormal mammogram result, your doctor will need to perform further investigations to reach a definitive diagnosis.
Diagnosis often begins with a breast exam, where your doctor manually checks your breasts and armpit for any lumps or abnormalities. If breast cancer is suspected, further imaging tests may be ordered:
If imaging tests show an unusual mass or suspicious skin thickening, a tissue sample is required for a definitive diagnosis. This process of removing and examining tissue under a microscope is called a biopsy.
For breast cancer, an image-guided core needle biopsy is typically performed. During this procedure, live imaging of the breast tissue helps the doctor accurately guide the needle to the suspected cancerous area. This is sometimes performed during the initial imaging appointment to expedite the diagnosis.
If the biopsy confirms cancerous tissue, additional imaging and biopsies may be needed to determine the exact scope of the disease, including whether the cancer has spread to nearby lymph nodes or other distant parts of the body.
Following a breast cancer diagnosis, the cancer cells are analysed to identify their molecular receptor subtype. This crucial step informs the development of a comprehensive, personalised treatment plan.
Breast cancer treatment is primarily centred on surgery, often combined with chemotherapy, radiation therapy, or both. Other treatment options may include targeted therapy and angiogenesis inhibitors. Treatment plans are always unique and tailored to the individual patient.
Most metaplastic breast cancers have a triple-negative receptor status. This means the cancer cells do not have high levels of the oestrogen receptor, progesterone receptor, or the HER2 gene/protein. As a result, drugs designed to target these specific features are not effective against triple-negative cancers, necessitating alternative treatment strategies.
If the cancer is diagnosed before it has spread beyond the breast and surrounding lymph nodes, treatment usually begins with chemotherapy, potentially combined with immunotherapy, to shrink the tumour. This initial therapy is then followed by surgery and, in some cases, radiation therapy.
If the cancer has spread beyond the breast and surrounding lymph nodes, it is generally treated with chemotherapy or other cancer drugs, either alone or in combination. Radiation therapy may also be used as a palliative measure to reduce pain caused by a tumour mass.
Many patients undergo a form of surgery as part of their treatment. Chemotherapy or targeted therapy may be given before surgery to shrink the tumour, making the procedure and recovery easier. There are two main categories of surgery:
In both lumpectomy and mastectomy, surgeons may also remove nearby lymph nodes. These nodes are examined for cancer cells, which helps determine the risk of the disease spreading further and guides the need for additional chemotherapy and radiation therapy.
SSCHRC's breast cancer surgeons are among the most skilled and renowned in the world. They perform a large number of breast cancer surgeries each year, employing the least-invasive and most effective techniques.
Chemotherapy involves the use of powerful drugs to directly kill cancer cells, control their growth, or provide pain relief. It is frequently administered before surgery to shrink the tumour and simplify the procedure. Patients can receive chemotherapy either orally or intravenously.
Radiation therapy uses carefully directed beams of energy designed to destroy breast cancer cells.
It can be used before surgery to reduce the size of large tumours, or after surgery to kill any remaining cancer cells that are undetectable to the naked eye. Following a lumpectomy, patients often receive three to four weeks of daily radiation therapy, or sometimes one to two weeks. When lymph nodes are involved or a mastectomy is performed, patients usually require about six weeks of daily radiation therapy.
For metastatic breast cancer, radiation can be used as palliative care to reduce symptoms caused by cancer spread and improve the patient's quality of life.
Radiation therapy treatments offered at SSCHRC include:
At SSCHRC's Breast Centre, our radiation oncologists are exclusively dedicated to breast cancer care, providing them with the deep experience needed to design highly effective treatment plans.
Cancer cells rely on specific molecules (proteins) to survive, multiply, and spread. Targeted therapies work by interfering with, or 'targeting,' these molecules or the genes that produce them, thereby stopping or slowing cancer growth.
In recent years, targeted therapy has significantly improved the prognosis for breast cancer subtypes that were previously considered difficult to treat.
Angiogenesis is the process by which a tumour creates new blood vessels to increase its blood supply and grow rapidly. Vascular Endothelial Growth Factor (VEGF) is a key molecule controlling this process.
Researchers developed drugs called angiogenesis inhibitors, or anti-angiogenic therapy, to disrupt this growth. These drugs bind themselves to VEGF molecules or receptor proteins, thereby prohibiting them from activating new blood vessel formation.