Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Endocrinol (Lausanne). 2021 Apr 23;12:628939. doi: 10.3389/fendo.2021.628939. eCollection 2021.
Metaplastic breast cancer (MBC) is a rare and aggressive subtype of the breast. To understand the characteristics and prognosis of single hormone receptor-positive (HR+) MBC (estrogen receptor-positive [ER+]/progesterone receptor-negative [PR-] and ER-/PR+), we compared these tumors to double HR+ tumors as well as HR- tumors.
The Surveillance, Epidemiology, and End Results database was used to analyze MBC between 1975 and 2016. The effect of HR status was evaluated using a multivariate Cox regression model.
We included 3369 patients with a median follow-up time of 42 months (range 0-322 months). In this study, 280 (8.3%) cases were double HR+ tumors, 2597 (77.1%) were double HR- tumors, and 492 (14.6%) cases were single HR+ tumors, of which 159 (4.7%) cases were ER-/PR+ tumors and 333 (9.9%) were ER+/PR- tumors. On multivariate Cox analysis, the prognosis was related to age, race/ethnicity, tumor grade, TNM stage, and surgery. HR status remained no impact on breast cancer-specific survival (BCSS). In the Kaplan-Meier curve, HR status was not associated with better BCSS or overall survival (OS). In patients without HER2 overexpression, the BCSS and OS of ER+/PR- and ER-/PR+ tumors were not significantly different from that of ER-/PR- and ER+/PR+ tumors. The difference remains no significant in patients with HER2 overexpression.
In comparison with both ER-/PR- and ER+/PR+ tumors, we have identified clinically and biologically distinct features of single HR+ tumors. In patients with or without HER2 overexpression, the prognosis of single HR+ tumors was similar to ER-/PR- and ER+/PR+ tumors.
化生性乳腺癌（MBC）是一种罕见且侵袭性的乳腺癌亚型。为了了解单激素受体阳性（HR+）MBC（雌激素受体阳性[ER+]/孕激素受体阴性[PR-]和 ER-/PR+）的特征和预后，我们将这些肿瘤与双 HR+肿瘤以及 HR-肿瘤进行了比较。
使用监测、流行病学和最终结果数据库分析了 1975 年至 2016 年间的 MBC。使用多变量 Cox 回归模型评估 HR 状态的影响。
我们纳入了 3369 例中位随访时间为 42 个月（范围 0-322 个月）的患者。在这项研究中，280（8.3%）例为双 HR+肿瘤，2597（77.1%）例为双 HR-肿瘤，492（14.6%）例为单 HR+肿瘤，其中 159（4.7%）例为 ER-/PR+肿瘤，333（9.9%）例为 ER+/PR-肿瘤。多变量 Cox 分析显示，预后与年龄、种族/民族、肿瘤分级、TNM 分期和手术有关。HR 状态对乳腺癌特异性生存（BCSS）没有影响。在 Kaplan-Meier 曲线中，HR 状态与更好的 BCSS 或总生存（OS）无关。在没有 HER2 过表达的患者中，ER+/PR-和 ER-/PR+肿瘤的 BCSS 和 OS 与 ER-/PR-和 ER+/PR+肿瘤无显著差异。在 HER2 过表达的患者中，差异仍然不显著。
与 ER-/PR-和 ER+/PR+肿瘤相比，我们已经确定了单 HR+肿瘤具有独特的临床和生物学特征。在有或没有 HER2 过表达的患者中，单 HR+肿瘤的预后与 ER-/PR-和 ER+/PR+肿瘤相似。
