Breast spindle cell malignancies are rare. No standard treatment exists.
The Surveillance, Epidemiology, and End Results database was used to identify patients with breast spindle cell malignancies, 1992 to 2011. Descriptive statistical analysis and survival analysis were performed.
A total of 286 patients were identified (98.6% female). Approximately, 15% had estrogen receptor–positive tumors and 12.5% had progesterone receptor–positive tumors. Nearly 38% underwent partial mastectomy, whereas 55.5% underwent mastectomy. The frequency of partial mastectomy has increased in more recent years. One-third received radiation. Lymph node metastases were infrequent (9.3%) and distant metastases were uncommon (6.1%). Ten-year survival rates for patients with early-stage (I and II) disease were 83.9% after partial mastectomy, 86.7% after partial mastectomy plus radiation, and 71.6% after complete mastectomy. Three-year survival rates for patients with late-stage (III and IV) disease were low with 40.0% after complete mastectomy and 0% after complete mastectomy plus radiation.
This nationally representative analysis demonstrates that early-stage spindle cell carcinoma of the breast is adequately treated by partial mastectomy. Radiation may be considered for small, potentially early survival benefit. For late stage disease, complete mastectomy is appropriate; however, survival is poor, and radiation contributes no significant additional benefit.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to The American Journal of Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Spindle cell carcinoma of the breast: a case series of a rare histological subtype.Eur J Surg Oncol. 2003; 29: 600-603
- Spindle cell carcinoma of the breast as complex cystic lesion: a case report.Cancer Biol Med. 2014; 11: 130-133
- Spindle cell carcinoma of the breast.Jpn J Clin Oncol. 1997; 27: 46-50
- Spindle cell carcinoma of the breast. A clinocopathologic and ultrastructural study.Hum Pathol. 1981; 12: 550-561
- Metaplastic carcinomas of the breast. II. spindle cell carcinoma.Hum Pathol. 1989; 20: 732-740
- Wide spectrum screening keratin as a marker of metaplastic spindle cell carcinoma of the breast: an immunohistochemical study of 24 patients.Histopathology. 2002; 40: 556-562
- A 59-year-old woman with a spindle cell lesion of the breast. Low-grade (fibromatosis-like) spindle cell carcinoma of the breast.Arch Pathol Lab Med. 2006; 130: e81-e83
- Metaplastic breast carcinoma: clinical-pathologic characteristics and HER2/neu expression.Breast Cancer Res Treat. 2005; 91: 173-178
- Spindle cell carcinoma of the breast: four cases and review of the literature.Hum Pathol. 1984; 15: 147-152
- Low-grade fibromatosis-like spindle cell metaplastic carcinoma: a basal-like tumor with a favorable clinical outcome: report of two cases.Tumori. 2009; 95: 264-267
- Spindle cell metaplastic breast carcinoma with leiomyoid differentiation: a case report.Breast Care (Basel). 2011; 6: 230-233
- Metaplastic carcinoma of the breast. A clinicopathologic study of 29 patients.Am J Surg Pathol. 1987; 11: 918-929
- Metaplastic breast tumors with a dominant fibromatosis-like phenotype have a high risk of local recurrence.Cancer. 1999; 85: 2170-2182
- The accuracy of preoperative core biopsy in determining histologic grade, hormone receptors, and human epidermal growth factor receptor 2 status in invasive breast cancer.Am J Surg. 2009; 197: 266-269
- Do the histologic features and results of breast cancer biomarker studies differ between core biopsy and surgical excision specimens?.Breast. 2006; 15: 167-172
- Surgical specimen can be replaced by core samples in assessment of ER, PR and HER-2 for invasive breast cancer.Acta Oncol. 2008; 47: 38-46
- Discordance between core needle biopsy (CNB) and excisional biopsy (EB) for estrogen receptor (ER), progesterone receptor (PgR) and HER2 status in early breast cancer (EBC).Ann Oncol. 2009; 20: 1948-1952
- Discordance in early breast cancer for tumour grade, estrogen receptor, progesteron receptors and human epidermal receptor-2 status between core needle biopsy and surgical excisional primary tumour.Breast. 2011; 20: 284-287
- Reliability of core needle biopsy for determining ER and HER2 status in breast cancer.Ann Oncol. 2013; 24: 931-937
- A comparative analysis of core needle biopsy and final excision for breast cancer: histology and marker expression.Am J Surg. 2011; 201: 692-694
- Is preoperative core biopsy accurate in determining the hormone receptor status in women with invasive breast cancer?.Int Semin Surg Oncol. 2005; 22: 15
Published online: January 06, 2016
Received in revised form: November 12, 2015
Received: June 2, 2015
The authors declare no conflicts of interest.
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.