Clinical characteristics and prognosis in 20 patients with spindle cell carcinoma of the breast

OBJECTIVE: To investigate the clinical features, appropriate diagnosis and prognosis of spindle cell carcinoma of the breast (SpCC). METHODS: Clinicopathological data of 20 patients with histopathologically confirmed breast SpCC treated in Tianjin Cancer Hospital from 2004 to 2013 were reviewed retrospectively. The survival rate was calculated by Kaplan-Meier analysis. RESULTS: All the patients were female and their median age was 54 years. The median maximum diameter of the tumor was 3.8 cm. The misdiagnosis rate was high by mammography, B-ultrasound and core needle biopsy (CNB) before operation. So that the diagnosis primarily depended on postoperative histopathological examination. The positive expression rate of estrogen receptor (ER), progesterone receptor (PR) and human-epidermal growth factor receptor-2 (HER-2) was low. The over-expression rate of Ki-67 was 68.8%. The positive expression rate of EGFR was 63.6%. The median follow-up time of the 20 patients was 32 months and their 3-year overall survival rate and 3-year disease-free survival rate were 80.6% and 57.2%, respectively. CONCLUSIONS: Spindle cell carcinoma of the breast is rare and has a poor prognosis. The expressions of ER, PR and HER-2 in most samples are negative, Ki-67 is overexpressed, and positive rate of EGFR is high. This disease is highly invasive, and the best treatment modality is comprehensive therapy mainly based on radical resection.