Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, 31-115 Krakow, Poland.
Breast Cancer Unit, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland.
Acta Oncol. 2024 Aug 4;63:620-635. doi: 10.2340/1651-226X.2024.40413.
Metaplastic breast carcinoma (BC-Mp) is an uncommon subtype that poses unique challenges. The limited information on patient prognosis and therapeutic strategies motivated our research initiative. We aimed to assess disease-free survival (DFS), overall survival (OS), and influential factors in patients with nonmetastatic BC-Mp.
In this multicenter retrospective cohort study, clinicopathological data for nonmetastatic BC-Mp patients treated at four oncology units in Poland (2012-2022) were gathered.
Among 115 women (median age 61, range: 28-91), the median tumor size was 40 mm (range 20-130); 30% of patients exhibited positive local lymph nodes. The majority of patients presented with stage II (46%) and triple-negative breast cancer (TNBC) (84%). Radiotherapy was administered to 61% of patients. Surgical procedures included breast-conserving surgery in 31% of patients and mastectomy in 68%. Eighty-three per cent of patients received chemotherapy. The median estimated DFS and OS were 59 and 68 months, respectively. Multivariable analysis revealed that tumor size influenced DFS and OS (Hazard ratios [HR] = 1.02, 95%CI 0.01-0.03 for both endpoints) and taxanes application improved DFS (HR = 0.47, 95%CI 0.24-0.93), but other factors did not. For patients receiving neoadjuvant systemic therapy (N = 51), taxanes improved DFS and OS according to univariable analysis.
Our findings highlight poor DFS and OS regardless of receiving optimal treatment, emphasizing the need for tailored therapeutic strategies for BC-Mp patients. Taxanes appear promising in a neoadjuvant setting, particularly within the current standard of care for the TNBC subtype.
化生性乳腺癌（BC-Mp）是一种罕见的亚型，具有独特的挑战。由于缺乏关于患者预后和治疗策略的信息，我们开展了此项研究。我们旨在评估非转移性 BC-Mp 患者的无病生存（DFS）、总生存（OS）和影响因素。
在这项多中心回顾性队列研究中，我们收集了波兰 4 个肿瘤学单位（2012-2022 年）治疗的非转移性 BC-Mp 患者的临床病理数据。
115 名女性患者（中位年龄 61 岁，范围：28-91 岁）中，肿瘤大小的中位数为 40mm（范围 20-130mm）；30%的患者存在局部淋巴结阳性。大多数患者为 II 期（46%）和三阴性乳腺癌（TNBC）（84%）。61%的患者接受了放疗。手术方式包括保乳手术（31%）和乳房切除术（68%）。83%的患者接受了化疗。中位估计 DFS 和 OS 分别为 59 个月和 68 个月。多变量分析显示肿瘤大小影响 DFS 和 OS（DFS 和 OS 的风险比[HR]分别为 1.02，95%CI 0.01-0.03），紫杉烷类药物的应用改善了 DFS（HR=0.47，95%CI 0.24-0.93），但其他因素没有。对于接受新辅助全身治疗（N=51）的患者，紫杉烷类药物根据单变量分析改善了 DFS 和 OS。
无论接受何种最佳治疗，我们的研究结果均显示患者的 DFS 和 OS 较差，这强调了为 BC-Mp 患者制定个体化治疗策略的必要性。紫杉烷类药物在新辅助治疗中具有较好的应用前景，特别是在 TNBC 亚型的当前标准治疗中。
