Do you need chemo to battle metaplastic breast Cancer?
Do you need Chemo to battle
Metaplastic Breast Cancer?
Can you treat metaplastic breast
cancer with only radiation?
• It is often stated that chemo does not work with
metaplastic breast cancer (MBC). However, it is given
as the strongest possible deterrent to reoccurrence
after surgery. This case study aims to detail the
scenario of a 70 year old woman who declined
conventional treatment for metaplastic breast cancer.
• The 70 year old female was offered a radical
mastectomy, chemotherapy (FECx6) and radiation.
Instead she only had radiation.
i. T2, N0 metaplastic
breast carcinoma was
found on the right
i. Another 2mm lobular
carcinoma was also
i. The mass was Triple
Negative and slightly
The patient discovered a
mass on her breast in May
2011. The original mass
was 1.9cm but it grew to
3cm by July 2012 when it
was biopsied. The mass
was originally considered
to be a cyst. It was
removed in September
2011. Following removal
came radiation therapy for
one month. The patient
refused her doctor’s advice
and did not have
July 2011 Nov 2011 March 2012 2012May 2011 2013
Found a lump
Solid lump found by
patient in May 2011.
Visited family doctor.
Removal of tumour
TNBC, KI67 +, MBC
spindle cell plus 2mm
The patient was cancer
free for the whole of
Due to ultrasound and
40GY of radiation
New possible Cancer
found in the leg. A
mass growing outside
of the leg resembling a
boob with a nipple
CANCER TIMELINE – Metaplastic Breast Cancer Spindle Cell
See Above 40 GY
Timeline in 2011
Course ID Plan ID RX Dose Fraction
1R + Breast RT Boost 10 5/5
1R+ Breast RT Boost 40 15/15
New Cancer found in 2013
• The patient was cancer free for one year.
• Found a suspicious lesion on her right calf in January 2013
which was dismissed by her doctor. The lump continued to
grown and was a mass outside of her skin. In September
she was initially diagnosed as a metaplastic lesion.
• Examination – 2x1.5cm erythematous nodule over the
medial aspect of the right calf.
• Diagnosis – after operation and removal in December 2013
- cystic lesion right leg with squamous cell carcinoma in situ
with a cyst wall.
• According to her medical team there was no evidence of
any relation to the old cancer.
Sept 2013 Dec 2013 Dec 2013 2013Jan 2013 2014
Found new lesion on
leg of 72 year old
female patient with
history of MBC
Removal of tumour
Due to previous cancer
quick removal of new
Patient opted out of all
treatment for new
Patient went for an
ultrasound and was
Diagnosis: 2x1.5 cystic
lesion with squamous
cell carcinoma in Situ
with a cyst wall.
The patient is currently
CANCER TIMELINE – Squamous Cell Carcinoma in Situ
Medics state that there are no similarities between both
cancers but there are similarities that cannot be dismissed
All cancer was on the right side of the body. Both cancers were
originally perceived to be cysts. One cancer was treated slowly and
grew to include a whole new cancer (lobular) on removal – despite
showing large cells at biopsy.
Her original pathology shows Spindle Cell and her new cancer
is Squamous – both are sub-types of MBC. Furthermore,
crystallised forms of tumour were discovered but were not
tested. The first cancer had a chance to grow and was more
aggressive. The second cancer had a change to grow from 0-
2cm but wasn’t biopsied. The cyst that was profiled showed
Suamous elements hance her diagnosis. This means that new
growth patterns could not be assessed.
• Even though doctors disagree. We believe that there
are some similarities between the patients cancer. Her
leg biopsy was botched despite showing crystallised
formations that resemble a metaplastic tumour.
• But, this is overshadowed, by the fact, that the lady
despite an aggressive diagnosis has survived MBC with
only one reoccurrence. This is without doing
chemotherapy. This must show a positive outcome for
patients with a similar T2, NO diagnosis.
• In 2014 the lady is alive and well with no existing
cancer. Current medication includes Statin and
Quick synopsis of 6 known patients
that chose radiation only
Squamous Grade 1
MBC one 1.5 years
cancer free and
one 4 years cancer
Our 70 year old
case study with
Squamous and 1
woman with Grade
2 MBC – 1 year
52 year old woman
With only six women we know of
that have chosen only radiation:
mere assumptions can be made.
Low grade MBC (under 2A) and no
lymph nodes can be treated with
radiation after surgery. Four women
have had success.
However more aggressive tumours
(above 2b) should be treated more
aggressively. However, a
reoccurrence did occur in this case
and maybe chemo would be the
preferred choice for a cancer free
Please contact me: firstname.lastname@example.org
We are actively looking for a PhD student or similar to analyse our data