Do you need chemotherapy to fight metaplastic breast cancer? Case study of a 70 year old woman who only had radiation therapy to battle Spindle Cell metaplastic breast cancer.

1. Do you need Chemo to battle
Metaplastic Breast Cancer?

2. 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.

3. Patient History
i. T2, N0 metaplastic
breast carcinoma was
found on the right
breast.
i. Another 2mm lobular
carcinoma was also
found.
i. The mass was Triple
Negative and slightly
KI67 positive.
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
chemotherapy.

4. 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
lobular carcinoma
Cancer free
The patient was cancer
free for the whole of
2012
Biopsy
Due to ultrasound and
mammogram mass
considered threatening
with sarcomatoid
features
Radiation
40GY of radiation
therapy completed.
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
http://www.metaplasticbreastcancer.net
http://www.benaroberts.com

5. Lymph Node
(0/5)
HER2 Negative
Radiation
Treatment
Plan
See Above 40 GY
BRCA Negative
2 completely
different types
of cancer
MBC and
Lobular
2012201220112011
Timeline in 2011
Course ID Plan ID RX Dose Fraction
1R + Breast RT Boost 10 5/5
1R+ Breast RT Boost 40 15/15

6. Image of Breast Scar

7. 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.

8. 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
lesion
No treatment
Patient opted out of all
treatment for new
cancer
Patient went for an
ultrasound and was
treated quickly
Diagnosis: 2x1.5 cystic
lesion with squamous
cell carcinoma in Situ
with a cyst wall.
Cancer Free
The patient is currently
cancer free
CANCER TIMELINE – Squamous Cell Carcinoma in Situ
Http://www.facebook.com/metaplasticbc
http://www.facebook.com/metaplasticbreastcan
cer

9. Image of leg scar

10. 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.

11. Conclusion
• 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
Pantropozole.

12. Quick synopsis of 6 known patients
that chose radiation only
Two women
Squamous Grade 1
MBC one 1.5 years
cancer free and
one 4 years cancer
free
Carcinocarcinoma
patient with
radiation only.
Reoccurrence and
mets. Deceased.
Our 70 year old
case study with
Squamous and 1
similarly aged
woman with Grade
2 MBC – 1 year
cancer free
52 year old woman
– undisclosed
details
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
future.

13. BENA ROBERTS
WWW.BENAROBERTS.COM
WWW.METAPLASTICBREASTCANCER.NET
Please contact me: benabroberts@gmail.com
We are actively looking for a PhD student or similar to analyse our data