Frontiers in oncology · 2026
Metaplastic breast carcinoma with osteosarcomatous differentiation: a case report.
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Zhao Xiang, Sun XiaoYu, Liu Jiaqi
Аннотация
BACKGROUND: Metaplastic breast carcinoma (MBC) is a rare and aggressive malignancy accounting for less than 0.2-1% of all breast cancers. MBC with osteosarcomatous differentiation is extremely rare (0.003%-0.12%) and presents significant diagnostic and therapeutic challenges.
CASE PRESENTATION: We report a case of a 65-year-old female with history of breast-conserving surgery for left breast invasive carcinoma in 2021, who presented with a recurrent left breast mass in December 2025. After adjuvant therapy including ACT chemotherapy, radiotherapy and capecitabine, imaging revealed a 4.47 x 3.4 x 2.8 cm irregular mass with calcifications. Core needle biopsy suggested metaplastic carcinoma. After 4 cycles of TP plus immunotherapy showing stable disease, modified radical mastectomy was performed. Final pathology confirmed MBC with osteosarcomatous differentiation (4.5 x 3 x 3 cm), triple-negative with SATB2 positivity and Ki-67 70%. Postoperative BRCA1/2 testing was negative, and adjuvant AC chemotherapy combined with immunotherapy was administered.
CONCLUSION: This case highlights the diagnostic challenges and treatment considerations for MBC with osteosarcomatous differentiation. Multimodality treatment including surgery, anthracycline-based chemotherapy, immunotherapy, and radiotherapy may provide optimal outcomes.
CASE PRESENTATION: We report a case of a 65-year-old female with history of breast-conserving surgery for left breast invasive carcinoma in 2021, who presented with a recurrent left breast mass in December 2025. After adjuvant therapy including ACT chemotherapy, radiotherapy and capecitabine, imaging revealed a 4.47 x 3.4 x 2.8 cm irregular mass with calcifications. Core needle biopsy suggested metaplastic carcinoma. After 4 cycles of TP plus immunotherapy showing stable disease, modified radical mastectomy was performed. Final pathology confirmed MBC with osteosarcomatous differentiation (4.5 x 3 x 3 cm), triple-negative with SATB2 positivity and Ki-67 70%. Postoperative BRCA1/2 testing was negative, and adjuvant AC chemotherapy combined with immunotherapy was administered.
CONCLUSION: This case highlights the diagnostic challenges and treatment considerations for MBC with osteosarcomatous differentiation. Multimodality treatment including surgery, anthracycline-based chemotherapy, immunotherapy, and radiotherapy may provide optimal outcomes.