Paul Wright G, Davis Alan T, Koehler Tracy J, Melnik Marianne K, Chung Mathew H
GRMEP/MSU General Surgery Residency Program, Grand Rapids, MI, USA,
Ann Surg Oncol. 2014 Oct;21(11):3497-503. doi: 10.1245/s10434-014-3782-7. Epub 2014 May 17.
Metaplastic breast cancer is a rare histologic variant among breast cancers. We sought to investigate the impact of hormone receptor status in metaplastic breast cancer and compare outcomes with common histologic variants of breast cancer.
The study was performed utilizing the Surveillance, Epidemiology, and End Results database. A query was made for patients with metaplastic breast cancer from 2000 to 2010. A separate query identified all patients with infiltrating ductal (IDC) or lobular (ILC) carcinoma during the same period. Effect of hormone receptor status was evaluated using Cox regression analysis. Significance was assessed for p < 0.05.
A total of 2,338 patients with metaplastic breast cancer were available for study. Most tumors were hormone receptor negative (79.0 %) and greater than or equal to grade 3 (82.9 %). For comparison, 382,667 and 44,813 patients with IDC and ILC, respectively, were obtained. Overall 5-year survival for metaplastic breast cancer was 62.2 % compared with 81.2 % for IDC (p < 0.001) and 80.2 % for ILC (p < 0.001). For metaplastic cases, no difference in 5-year survival was found between hormone-positive and hormone-negative tumors (65.7 vs. 63.5 %; p = 0.70). Multivariate analysis demonstrated metaplastic histology as an independent risk factor for cancer-related mortality both among hormone-positive (hazard ratio [HR] 2.4; 95 % confidence interval [CI] 1.8-3.0; p < 0.001) and hormone-negative (HR 1.7; 95 % CI 1.5-1.9; p < 0.001) breast cancers.
Metaplastic breast cancer is an aggressive histologic variant that portends a poor prognosis compared with common breast cancer subtypes. Contrary to other breast cancers, hormone receptor positivity does not improve prognosis in metaplastic breast cancer.
化生性乳腺癌是乳腺癌中一种罕见的组织学变异类型。我们试图研究激素受体状态在化生性乳腺癌中的影响，并将其预后与常见的乳腺癌组织学变异类型进行比较。
本研究利用监测、流行病学和最终结果数据库进行。查询了2000年至2010年间患有化生性乳腺癌的患者。另一个查询确定了同期所有浸润性导管癌（IDC）或小叶癌（ILC）患者。使用Cox回归分析评估激素受体状态的影响。p < 0.05为有统计学意义。
共有2338例化生性乳腺癌患者可供研究。大多数肿瘤激素受体阴性（79.0%）且大于或等于3级（82.9%）。作为对照，分别获得了382667例IDC患者和44813例ILC患者。化生性乳腺癌的总体5年生存率为62.2%，而IDC为81.2%（p < 0.001），ILC为80.2%（p < 0.001）。对于化生性乳腺癌病例，激素阳性和激素阴性肿瘤的5年生存率无差异（65.7%对63.5%；p = 0.70）。多因素分析表明，化生性组织学是激素阳性（风险比[HR] 2.4；95%置信区间[CI] 1.8 - 3.0；p < 0.001）和激素阴性（HR 1.7；95% CI 1.5 - 1.9；p < 0.001）乳腺癌患者癌症相关死亡的独立危险因素。
化生性乳腺癌是一种侵袭性的组织学变异类型，与常见的乳腺癌亚型相比预后较差。与其他乳腺癌相反，激素受体阳性并不能改善化生性乳腺癌的预后。
