Hebei Medical University, Shijiazhuang, China.
Department of Breast Cancer Center, The Fourth Hospital of Hebei Medical University, No. 12, Jian-Kang Road, Shijiazhuang, 050011, China.
World J Surg Oncol. 2023 Nov 24;21(1):364. doi: 10.1186/s12957-023-03261-w.
Metaplastic breast cancer(MBC) is a specific pathological type of invasive breast cancer. There are few studies related to MBC due to its rarity. This study aimed to analyse the differences in clinicopathological characteristics and prognosis between Metaplastic breast cancer and triple-negative invasive ductal carcinoma (TN-IDC).
We retrospectively compared the clinicopathological characteristics of patients diagnosed with MBC and TN-IDC at the Fourth Hospital of Hebei Medical University between 2011 and 2020 in a 1:2 ratio. The log-rank test was used to compare the two groups' disease-free survival (DFS) and overall survival (OS). For MBCs, we performed univariate and multivariate analyses using the Cox proportional hazards model to determine the characteristics that impacted OS and DFS.
A total of 81 patients with MBC and 162 patients with TN-IDC were included in this study. At initial diagnosis, MBC patients had larger tumour diameters(P = 0.03) and fewer positive lymph nodes (P = 0.04). Patients with MBC were more likely to have organ metastases after surgery (P = 0.03). Despite receiving the same treatment, MBC patients had worse DFS (HR = 1.66, 95%CI 0.90-3.08, P = 0.11) and OS (HR = 1.98, 95% CI 1.03-3.81, P = 0.04), and OS was statistically significant. Positive lymph nodes at initial diagnosis were associated with worse DFS (HR = 3.98, 95%CI 1.05-15.12, P = 0.04) and OS (HR = 3.70, 95%CI 1.03-13.34, P = 0.04) for patients with MBC. The efficacy of platinum-based agents is insensitive for MBC patients receiving chemotherapy. In addition, patients treated with preoperative chemotherapy had worse DFS compared to patients treated with postoperative chemotherapy (HR = 3.51, 95%CI 1.05-11.75, P = 0.04).
The clinicopathological characteristics and prognosis of MBC and TN-IDC differ in many ways. Further studies are required to determine suitable treatment guidelines for patients with MBC.
化生性乳腺癌（MBC）是一种特殊的浸润性乳腺癌病理类型。由于其罕见性，相关研究较少。本研究旨在分析化生性乳腺癌与三阴性浸润性导管癌（TN-IDC）在临床病理特征和预后方面的差异。
我们回顾性比较了 2011 年至 2020 年在河北医科大学第四医院以 1:2 比例诊断为 MBC 和 TN-IDC 的患者的临床病理特征。使用对数秩检验比较两组患者的无病生存（DFS）和总生存（OS）。对于 MBC，我们使用 Cox 比例风险模型进行单因素和多因素分析，以确定影响 OS 和 DFS 的特征。
本研究共纳入 81 例 MBC 患者和 162 例 TN-IDC 患者。在初始诊断时，MBC 患者的肿瘤直径较大（P=0.03），阳性淋巴结较少（P=0.04）。MBC 患者术后更易发生器官转移（P=0.03）。尽管接受了相同的治疗，MBC 患者的 DFS 更差（HR=1.66，95%CI 0.90-3.08，P=0.11）和 OS（HR=1.98，95%CI 1.03-3.81，P=0.04），OS 具有统计学意义。初始诊断时的阳性淋巴结与 MBC 患者的 DFS（HR=3.98，95%CI 1.05-15.12，P=0.04）和 OS（HR=3.70，95%CI 1.03-13.34，P=0.04）较差相关。接受化疗的 MBC 患者对铂类药物的疗效不敏感。此外，与术后化疗相比，接受术前化疗的患者 DFS 更差（HR=3.51，95%CI 1.05-11.75，P=0.04）。
MBC 和 TN-IDC 在临床病理特征和预后方面存在许多差异。需要进一步研究以确定 MBC 患者的合适治疗指南。
