Introduction. Metaplastic breast carcinoma is a rare special type of breast cancer, which has distinguished clinical characteristics. We aimed to evaluate the clinicopathological features of metaplastic breast carcinoma compared with nonspecific invasive breast carcinoma and study the prognosis of metaplastic breast carcinoma. Methods. We reviewed metaplastic breast carcinoma cases (n = 37) from January 2000 to December 2021 and nonspecific invasive breast carcinoma cases (n = 433) from January 2019 to December 2020 extracted from our institution retrospectively. The following variables were recorded, including the patients’ general information, complications, T stage, expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, Ki-67, molecular subtyping, lymph node status, skin or chest wall involvement, vessel carcinoma embolus, therapy modality (surgical treatments, chemotherapy, and radiotherapy), and survival. Results. Patients with metaplastic breast carcinoma had more advanced disease than patients with nonspecific invasive breast carcinoma (T stage: ). A greater proportion of metaplastic breast carcinoma presented with triple-negative breast cancer than nonspecific invasive breast carcinoma (79.41% vs. 12.47%, ). Our study showed that the skin or chest wall invasion was more frequent in metaplastic breast carcinoma patients (11.76% vs. 1.62%, ). The 5-year survival rate for metaplastic breast carcinoma patients was 57.66% (95% CI: 0.3195∼0.7667). No local recurrence was observed while distant metastasis occurred in 33.33% of patients with metaplastic breast carcinoma. Death due to disease occurred in 24.24% of patients with metaplastic breast carcinoma. Conclusion. The majority of metaplastic breast carcinoma patients had more advanced disease and triple-negative disease than nonspecific invasive breast carcinoma patients. Also, metaplastic breast carcinoma patients had frequent skin or chest wall invasion and a high rate of distant metastasis and mortality.

Background: Breast carcinoma with neuroendocrine features includes neuroendocrine neoplasm of the breast and invasive breast cancer with neuroendocrine differentiation. This study aimed to investigate the clinicopathological features and prognosis of this disease according to the fifth edition of the World Health Organization classification of breast tumors. Materials and Methods: A total of 87 patients with breast carcinoma with neuroendocrine features treated in the First Medical Center, Chinese PLA General Hospital from January 2001 to January 2022 were retrospectively enrolled in this study. Results: More than half of the patients were postmenopausal patients, especially those with neuroendocrine neoplasm (62.96%). There were more patients with human epidermal growth factor receptor 2 negative and hormone receptor positive tumors, and most of them were Luminal B type (71.26%). The multivariate analysis showed that diabetes and stage IV disease were related to the progression-free survival of breast carcinoma with neuroendocrine features patients (p = 0.004 and p < 0.001, respectively). Conclusion: Breast carcinoma with neuroendocrine features tended to be human epidermal growth factor receptor 2 negative and hormone receptor positive tumors, most of them were Luminal B type, and the related factors of progression-free survival were diabetes and stage IV disease.

Objectives. Stage IIIC breast cancer, as a local advanced breast cancer, has a poor prognosis compared with that of early breast cancer. We further investigated the risk factors of mortality in stage IIIC primary breast cancer patients and their predictive value. Methods. We extracted data from the US Surveillance, Epidemiology, and End Results (SEER) database of female patients with stage IIIC primary breast cancer (n = 1673) from January 2011 to December 2015. Results. Hormone receptor negativity ( and , respectively), aggressive molecular typing ( and , respectively), high T stage ( and , respectively), a high number of positive lymph nodes (≥14) ( and , respectively), and lymph node ratio (≥0.8148) ( and , respectively) were associated with poor disease-specific survival. The indicators of disease-specific survival included estrogen receptor status, progesterone receptor status, molecular typing, T stage, number of positive lymph nodes, and lymph node ratio ( , , , , , and , respectively). Conclusion. Hormone receptor negativity, aggressive molecular typing, high T stage, high number of positive lymph nodes, and lymph node ratio are poor prognostic factors patients with stage IIIC primary breast cancer. The efficient indicators of disease-specific survival include estrogen receptor status, progesterone receptor status, molecular typing, T stage, number of positive lymph nodes, and lymph node ratio.

Background: The breast cancer tumour microenvironment (TME) exhibits marked cellular and metabolic heterogeneity that contributes to disease progression and therapeutic resistance. Lactylation, a lactate-derived post-translational modification, has emerged as a potential link between metabolic reprogramming and tumour-associated transcriptional and immune changes. However, its cell-type distribution and clinical relevance in breast cancer remain incompletely defined. Methods: We integrated 26 scRNA-seq samples spanning ER+, HER2+, and triple-negative breast cancer (TNBC), comprising 98,572 cells. A literature-curated lactylation-related transcriptional module score was calculated using AddModuleScore, and epithelial cells were stratified into high- and low-score states for downstream analyses. Candidate genes were prioritised by integrating single-cell differential expression, a curated lactylation-related gene pool, and tumour-associated expression changes in TCGA-BRCA. A 14-gene prognostic model was developed using LASSO-Cox regression in TCGA-BRCA and externally validated in GSE20685 and METABRIC. Additional analyses evaluated associations with immune infiltration, somatic alterations, and predicted drug sensitivity. Functional relevance was explored through CALR knockdown in breast cancer cells and xenograft assays. Results: Single-cell analysis identified six major cell populations and revealed marked subtype-related heterogeneity. Lactylation-associated transcriptional activity was highest in epithelial cells, particularly in TNBC, and was associated with pathways related to immune response, cell cycle, and metabolic adaptation. High-score epithelial states showed enhanced epithelial–fibroblast–myeloid communication and were linked to an immune-modulatory microenvironment with partial immune-suppressive features. The 14-gene signature stratified patients into significantly different prognostic groups in TCGA-BRCA and retained prognostic value in GSE20685 and METABRIC. Internal resampling suggested modest but reproducible discrimination, although measurable optimism was observed in the training cohort. High-risk tumours were associated with distinct immune/stromal patterns, whereas mutation-frequency differences and tumour mutation burden did not show robust group differences after statistical correction. CALR knockdown suppressed proliferation, induced G1-phase arrest and apoptosis, and reduced xenograft growth. Conclusions: This study defines a lactylation-associated transcriptional programme in breast cancer and links it to epithelial-state heterogeneity, microenvironmental remodelling, and patient prognosis. The proposed 14-gene signature may provide a transcriptome-based framework for risk stratification, but the findings should be interpreted cautiously because the lactylation score is an indirect surrogate rather than a direct measurement of lactylation itself. Further mechanistic and clinical validation will be required.