Clinicopathological characteristics and prognosis of metaplastic carcinoma of the breast

Abstract

Metaplastic carcinoma of the breast (MBC) is a rare and heterogeneous type of neoplasm. Knowledge about its clinical characteristics, prognostic significance and optimal treatment modalities is fragmentary and controversial. The present retrospective study aimed to investigate the prognostic value of the clinicopathological features and different therapeutic strategies in MBC. For this purpose, the medical records of 69 MBC patients subjected to surgical resection for MBC at the Tianjin Medical University Cancer Institute and Hospital (Tianjin, China) were reviewed. A total of 69 MBC cases were followed up for 9-139 months. The 5-year disease-free survival (DFS) rate was 52.2% and the overall survival (OS) rate was 60.2%. Survival analysis revealed that large tumor size and lymph node (LN) metastases were correlated with shortened 5-year DFS and OS rates. In addition, chemotherapy significantly improved the prognosis of patients with LN metastasis, while radiation therapy (RT) significantly improved the 5-year OS and DFS rates of MBC patients with tumors ≥5 cm or with >4 metastatic LNs. In conclusion, MBC is a clinically aggressive subtype of breast cancer associated with a large tumor size. Chemotherapy may be recommended for certain subtypes of MBC with LN positivity, and RT may be a component of multimodality therapy for some MBC patients.

Keywords: characteristics; metaplastic breast carcinoma; prognosis; therapy.

Figure 1.

Kaplan-Meier estimates of disease-free survival according to adjuvant chemotherapy for (A) all patients with metaplastic carcinoma of the breast (P=0.096), (B) LN⁻ group (P=0.663) and (C) LN⁺ group (P=0.008). LN, lymph node.

Figure 2.

Kaplan-Meier estimates of disease-free survival according to RT for (A) all patients with metaplastic carcinoma of the breast (P=0.539), (B) patients with tumors <5 cm and with <4 metastatic LNs (P=0.951) and (C) patients with tumors ≥5 cm or with >4 metastatic LNs (P=0.043). RT, radiation therapy; LN, lymph node.