Hu Jin, Zhang Huiqiong, Dong Fang, Zhang Ximeng, Wang Shuntao, Ming Jie, Huang Tao
Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Transl Oncol. 2021 May;14(5):101054. doi: 10.1016/j.tranon.2021.101054. Epub 2021 Mar 4.
Metaplastic breast cancer (MBC) is a rare and aggressive subtype of breast. However, the effect of molecular subtype on treatment and prognosis of MBC remains unclear.
The Surveillance, Epidemiology, and End Results database was used to analyze patients with MBC between 2010 and 2016. Molecular subtype was stratified to TN group (ER and PR-/HER2-), HER2 group (ER and PR-/HER2+, ER/PR+ and HER2+), and HR group (ER/PR+ and HER2-). The breast cancer-specific survival (BCSS) differences were estimated using multivariate Cox regression model and Kaplan-Meier curves.
We included 1665 patients with median follow-up time of 27 months (range 0-83 months). 1154 (69.3%), 65 (3.9%), and 446 (26.8%) patients presented in TN group, HER2 group, and HR group, respectively. On multivariate Cox analysis, the prognosis was related to age, tumor size, regional node metastasis, and surgery. Molecular subtype remained no impact on BCSS. Radiotherapy (RT) was associated with better prognosis. Patients cannot benefit from chemotherapy. In Kaplan-Meier curve, triple-negative (P = 0.047) and HR-positive (P = 0.006) patients receiving RT had a superior BCSS than that not RT. HER2-positive patients cannot benefit from RT. However, adjusted Kaplan-Meier survival model showed that triple-negative (P = 0.019) but not HER2-positive (P = 0.575) or HR-positive (P = 0.574) patients receiving RT had a superior BCSS than that not RT.
Molecular subtype is not associated with the better prognosis of MBC. Patients could benefit from RT. However, triple-negative but not HR-positive or HER2-positive patients have superior survival after receiving RT.
化生性乳腺癌（MBC）是一种罕见且侵袭性强的乳腺癌亚型。然而，分子亚型对MBC治疗及预后的影响仍不明确。
利用监测、流行病学和最终结果数据库分析2010年至2016年间的MBC患者。分子亚型分为TN组（雌激素受体和孕激素受体阴性/人表皮生长因子受体2阴性）、HER2组（雌激素受体和孕激素受体阴性/人表皮生长因子受体2阳性，雌激素受体/孕激素受体阳性且人表皮生长因子受体2阳性）和HR组（雌激素受体/孕激素受体阳性且人表皮生长因子受体2阴性）。采用多因素Cox回归模型和Kaplan-Meier曲线评估乳腺癌特异性生存（BCSS）差异。
我们纳入了1665例患者，中位随访时间为27个月（范围0 - 83个月）。TN组、HER2组和HR组分别有1154例（69.3%）、65例（3.9%）和446例（26.8%）患者。多因素Cox分析显示，预后与年龄、肿瘤大小、区域淋巴结转移及手术有关。分子亚型对BCSS无影响。放疗（RT）与较好的预后相关。患者无法从化疗中获益。在Kaplan-Meier曲线中，接受放疗的三阴性（P = 0.047）和HR阳性（P = 0.006）患者的BCSS优于未接受放疗者。HER2阳性患者无法从放疗中获益。然而，校正后的Kaplan-Meier生存模型显示，接受放疗的三阴性患者（P = 0.019）而非HER2阳性患者（P = 0.575）或HR阳性患者（P = 0.574）的BCSS优于未接受放疗者。
分子亚型与MBC的较好预后无关。患者可从放疗中获益。然而，接受放疗后，三阴性患者而非HR阳性或HER2阳性患者具有更好的生存率。
