The prognoses of metaplastic breast cancer patients compared to those of triple-negative breast cancer patients

Abstract

Metaplastic breast carcinoma (MBC) is a rare, heterogeneous breast cancer characterized by admixture of adenocarcinoma with metaplastic elements, low hormone receptor expression, and poor outcomes. The authors retrospectively reviewed the medical records of 47 MBC patients and 1,346 invasive ductal carcinoma (IDC) patients. Two hundred eighteen of the IDC patients were triple-negative (TN-IDC) for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2 (ER-/PR-/HER2-). Patients were surgically treated at the Samsung Medical Center between 2005 and 2009. The MBC patients presented with a larger tumor size, lower lymph node involvement, higher histological and nuclear grades, higher triple negativity (ER-/PR-/HER2-) and higher p53, CK5/6, and EGFR expressions compared with those of the IDC group. However, there were no significant differences in clinicopathological characteristics between MBC and TN-IDC. During the follow-up period (median duration of 30.3 months, range 2.6-56.3 months), seven (14.9%) MBC patients, and 98 (7.1%) IDC patients had disease recurrence. The three-year disease-free survival (DFS) rate was 78.1% in the MBC group and 91.1% in IDC group (P < 0.001). The three-year DFS rate was not significantly different between the MBC and TN-IDC groups (78.1 vs. 84.9%, P = 0.114). However, in patients with lymph node metastasis who underwent adjuvant chemotherapy, the three-year DFS rate was 44.4% in the MBC group and 72.5% in the TN-IDC group (P = 0.025). The authors found that MBC had a poorer clinical outcome than did IDC. In breast cancer patients with nodal metastasis, MBC had a poorer prognosis than did TN-IDC, despite adjuvant chemotherapy.

Current Progress in the Treatment of Metaplastic Breast Carcinoma

“…Chao et al found that 5 cases received adjuvant chemotherapy had a poorer OS than the patients who never take in chemotherapy (Chao et al, 1999). In the retrospective study by Bae et al, the 3-year DFS was worse than triple negative breast carcinoma for the lymphatic metastases (Bae et al, 2011). Several authors (Wargotz and Norris, 1989;Gutman et al, 1995) found no survival advantage for patients treated with chemotherapy for metastatic MBC patients and newer agents including gemcitabine, navelbine and herceptin were not encouraged.…”

“…MBC is usually negative for ER, PR and HER2, which is the so called triple-negative tumors (Wargotz and Norris, 1989;Bae et al, 2011). What was worse, MBC patients had poorer 3-year DFS compared to a similar group of triple-negative IDC patients (Barnes et al, 2005;Rauf et al, 2006).…”

“…It is frequently lymph node negative (Oberman, 1987;Pitts et al, 1991;Gutman et al, 1995;Chao et al, 1999;Rayson et al, 1999). MBC is an aggressive disease which is more likely to be negative for estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) (Wargotz and Norris, 1989;Bae et al, 2011). It is usually treated with mastectomy, radiotherapy and chemotherapy.…”

Metaplastic Breast Cancer Presenting as a Breast Abscess

“…In this study, we review the Mayo Clinic experience in the systemic treatment of metaplastic breast cancer. We also review all published English-language case series containing 10 or more patients [1][2][3][4].…”

The recent progress of neoadjuvant chemotherapy in triple negative breast cancer: A short review

“…However, not all TNBC are "basal-like" and these two terms cannot be used interchangeably. Histologically, the majority of TNBCs are invasive ductal carcinomas not-otherwise specified (IDC-NOS), but also rare entities such as medullary and metaplastic carcinomas, as well as apocrine and adenoid cystic carcinomas share the triple negative phenotype [6,7] . Analogously, the heterogeneity among TNBCs is confirmed by molecular analysis [8,9] .…”