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Review
. 2017 Aug;17(5):382-391.
doi: 10.1016/j.clbc.2017.04.009. Epub 2017 Apr 26.

Metaplastic Carcinoma of the Breast Is More Aggressive Than Triple-negative Breast Cancer: A Study From a Single Institution and Review of Literature

Dima El Zein  1 , Melissa Hughes  2 , Shicha Kumar  2 , Xuan Peng  3 , Tolutope Oyasiji  2 , Hossam Jabbour  1 , Thaer Khoury  4
Affiliations
Review

Metaplastic Carcinoma of the Breast Is More Aggressive Than Triple-negative Breast Cancer: A Study From a Single Institution and Review of Literature

Dima El Zein et al. Clin Breast Cancer. 2017 Aug.

Abstract

Background: We aimed to describe our experience with metaplastic breast carcinoma (MBC), evaluate its clinical outcome compared with triple-negative breast cancer (TNBC), and provide a through and comprehensive review of the literature to date.

Materials and methods: We reviewed MBC cases (n = 46) from our institution. The following variables were recorded: tumor histologic subtype, Nottingham grade, tumor size, lymph node status, Tumor, Node, Metastases stage, biomarkers profile, patient's age and race, therapy modality (chemotherapy and radiation), and survival (disease-free survival [DFS] and overall survival [OS]). The clinical and pathological data for TNBC (n = 508) cases were extracted from the breast cancer database. To compare the survival between MBC and TNBC, a subgroup of MBC cases (n = 40) were matched with TNBC cases (n = 40) on the basis of known prognostic confounders.

Results: There were 17 of 46 (37%) cases with mesenchymal differentiation, 12 (26.1%) squamous cell carcinoma, 14 (30.4%) spindle cell carcinoma, and 3 (6.5%) mixed type. MBC presented at a more advanced stage than TNBC (P = .014) and was more likely to recur (34% vs. 15.5%; P = .004). More MBC patients died from disease than TNBC (29% vs. 16%; P = .05). In the multivariate analysis, MBC had approximately twice the risk of local recurrence than TNBC (95% confidence interval, 1.01-3.83; P = .05). MBC patients had worse DFS and OS than the matched TNBC patients (P < .001 and P = .033, respectively). A review of the literature comparing MBC versus TNBC is presented.

Conclusion: Our results suggest that MBC is clinically more aggressive than TNBC. Further studies might help delineate the differences between these 2 entities.

Keywords: Disease free survival; Metaplastic breast carcinoma; Overall survival; Survival metaplastic carcinoma versus triple negative breast carcinoma; Triple-negative breast carcinoma.

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Figures

Figure 1
Figure 1
Histologic example of mixed MBC, mesenchymal differentiation (chondroid) and SCC (arrow marks squamous pearl) (4x).
Figure 2
Figure 2
Disease free (A) and overall (B) survival of MBC vs. TNBC (overall).
Figure 3
Figure 3
Disease free (A) and overall (B) survival of MBC vs. TNBC (matched).
Figure 4
Figure 4
Disease free (A) and overall (B) survival of MBC, pure vs. mixed with non-metaplastic component.
Figure 5
Figure 5
Disease free (A) and overall (B) survival of MBC, MBC with mesenchymal differentiation vs. SCC vs. spindle cell carcinoma. Note a trend towards less aggressive phenotype for MBC with mesenchymal differentiation.
See this image and copyright information in PMC

References

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