Clinicopathologic characteristics of HER2-positive metaplastic squamous cell carcinoma of the breast

J Clin Pathol. 2022 Jan;75(1):18-23. doi: 10.1136/jclinpath-2020-206468. Epub 2020 Nov 19.

Abstract

Aims: The aim of this study was to analyse the clinicopathological features and prognosis of human epidermal growth factor receptor-2 (HER2)-positive metaplastic squamous cell carcinoma (MSCC).

Methods: Fifty-eight patients with MSCC of the breast who were classified into 45 triple-negative and 13 HER2-positive subgroups diagnosed at the West China Hospital, Sichuan University, from 2004 to 2018, were enrolled. Clinicopathological features were collected and compared between HER2-positive MSCC, triple-negative MSCC, HER2-positive invasive breast carcinoma of no special type (NST) and triple-negative NST groups. In the prognostic survival analysis, HER2-positive MSCCs was compared with triple-negative MSCCs, HER2-positive NSTs and triple-negative NSTs.

Results: Compared with triple-negative MSCCs, more patients with Ki-67 low expression were in HER2-positive MSCCs (p<0.05). More patients with HER2-positive MSCC than patients with HER2-positive NST were postmenopausal (p<0.05). Compared among HER2-positive MSCCs, triple-negative MSCCs and triple-negative NSTs, patients of HER2-positive MSCCs with high Ki-67 expression were the least, and HER2-positive MSCCs had more strongly associated with postmenopausal disease status (p<0.05). In survival analyses, HER2-positive MSCCs had a high risk of recurrence and poor prognosis (p<0.05). Lymph node status was significantly associated with the disease-free survival of patients with HER2-positive MSCC.

Conclusion: In conclusion, our study indicates that HER2-positive MSCC is an aggressive disease with unique clinicopathological characteristics. Both HER2-positive status and an SCC component are critical factors for poor prognosis. HER2-positive MSCC and triple-negative MSCC are distinct subgroups. Corresponding targeted therapy recommendations should be made for this HER2-positive MSCC group.

Keywords: breast cancer; breast pathology; cancer research.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Breast / pathology
  • Breast Neoplasms / classification
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / pathology*
  • Carcinoma, Squamous Cell / classification
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / pathology*
  • China
  • Disease-Free Survival
  • Female
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization, Fluorescence
  • Middle Aged
  • Prognosis
  • Receptor, ErbB-2 / genetics
  • Receptor, ErbB-2 / metabolism*

Substances

  • ERBB2 protein, human
  • Receptor, ErbB-2