Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan; Comprehensive Breast Cancer Center, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan; Department of Research, Changhua Christian Hospital, Changhua, Taiwan; School of Medicine, National Yang Ming University, Taipei, Taiwan.
Breast. 2013 Oct;22(5):968-73. doi: 10.1016/j.breast.2013.05.010. Epub 2013 Jun 17.
Metaplastic carcinoma of the breast (MCB) is a rare histological subtype of breast cancer with an incidence of less than 0.1%-0.5%. Due to its rarity, the clinical characteristics and prognostic significance of MCB compared with other common breast cancers (like infiltrating ductal carcinoma [IDC], and infiltrating lobular carcinoma [ILC]) are not clear, and controversial among different reports.
We performed a collective comparison study of multi-institutional cases to evaluate the clinical characteristics and prognostic status of MCB to compare with IDC and ILC. A case control analysis was performed to minimize the bias from clinicopathologic factors between IDC and MCB. Disease free survival (DFS) and overall survival (OS) between groups were compared.
Forty-five MCB patients were enrolled from the 4 medical centers and compared with 1777 IDC and 53 ILC patients from the CCH cancer registry database comprise the current study. Compared with IDC, MCB was associated with older age, larger tumor size, a lesser lymph node positive rate, a higher likelihood of distant metastasis, higher tumor grade, lower ER-positive tumor, and higher triple negative breast cancer subtype (TNBC). MCB was associated with worse OS (p = 0.031) than IDC, but no difference in DFS (p = 0.071); however, MCB was not statistically different from ILC in both DFS and OS (p = 0.289 and 0.132, respectively). Compared with the case-controlled IDC group, MCB patients had poorer OS (p = 0.040), but no difference in DFS (p = 0.439).
MCB is associated with poorer OS than IDC, and this was related to tumor behavior rather than clinicopathologic factors.
乳腺的化生性癌（MCB）是一种罕见的乳腺癌组织学亚型，发病率低于 0.1%-0.5%。由于其罕见性，与其他常见乳腺癌（如浸润性导管癌[IDC]和浸润性小叶癌[ILC]）相比，MCB 的临床特征和预后意义尚不清楚，并且在不同的报告中存在争议。
我们进行了一项多机构病例的综合比较研究，以评估 MCB 与 IDC 和 ILC 相比的临床特征和预后状况。进行病例对照分析以最大程度地减少 IDC 和 MCB 之间临床病理因素的偏差。比较组间无病生存（DFS）和总生存（OS）。
从 4 家医疗中心共纳入 45 例 MCB 患者，并与 CCH 癌症登记数据库中的 1777 例 IDC 和 53 例 ILC 患者进行比较。与 IDC 相比，MCB 与年龄较大、肿瘤较大、淋巴结阳性率较低、远处转移可能性较高、肿瘤分级较高、ER 阳性肿瘤较少、三阴性乳腺癌（TNBC）亚型较高有关。MCB 的 OS （p = 0.031）比 IDC 差，但 DFS （p = 0.071）无差异；然而，在 DFS 和 OS 方面，MCB 与 ILC 无统计学差异（分别为 p = 0.289 和 0.132）。与病例对照 IDC 组相比，MCB 患者的 OS 较差（p = 0.040），但 DFS 无差异（p = 0.439）。
MCB 的 OS 比 IDC 差，这与肿瘤行为有关，而与临床病理因素无关。
