Wang Pin, Fang Huiying, Yang Dejuan, Liu Ying, Li Ling, Wu Jian
Department of General Surgery, The Third People's Hospital of Chengdu, Chengdu, China.
Center of Breast and Thyroid Surgery, The Third People's Hospital of Chengdu, Chengdu, China.
Front Oncol. 2025 May 12;15:1534204. doi: 10.3389/fonc.2025.1534204. eCollection 2025.
INTRODUCTION: Metaplastic breast carcinoma (MPBC) is a highly aggressive subtype of breast cancer, characterized by enhanced metastatic potential and invasive behavior. While surgery is a cornerstone of treatment, there is limited research on patients who did not undergo surgery. METHODS: We conducted a retrospective analysis of non-surgical MPBC patients using data from the Surveillance, Epidemiology, and End Results (SEER) database (1975-2019). Additionally, non-surgical MPBC patients were recruited from The Third People's Hospital of Chengdu, The First Affiliated Hospital of Chongqing Medical University, and the Chongqing University Cancer Hospital to form the clinical validation cohort (2010-2024). We collected demographic and clinical data, including age, race, marital status, tumor location, and treatment modalities, etc. The primary endpoints were overall survival (OS) and breast cancer-specific survival (BCSS). Statistical analyses were performed using R software, with Kaplan-Meier curves and Cox regression models for univariate and multivariate analyses. RESULTS: A total of 92 non-surgical MPBC patients were included from SEER database. The majority were aged≥60 years (65.22%), White (76.09%), and single (64.13%). Tumors were most frequently located in the upper quadrant (32.61%). Additionally, M1 patients were more likely to receive chemotherapy and radiotherapy compared to M0 patients (50.00% . 36.67%; 38.46% . 13.33%). Cox regression analysis identified chemotherapy and M stage as significant prognostic factors. Survival analysis showed that chemotherapy significantly improved OS and BCSS (<0.001), while radiotherapy had no significant impact on survival (>0.05). In the clinical cohort of 30 non-surgical MPBC patients, Kaplan-Meier curves demonstrated that chemotherapy significantly prolonged patient survival (=0.039), whereas radiotherapy did not show a significant effect on survival (=0.309). CONCLUSIONS: For MPBC patients who did not undergo surgery, chemotherapy significantly prolongs survival, highlighting its crucial role in treatment.
引言：化生性乳腺癌（MPBC）是一种侵袭性很强的乳腺癌亚型，其特点是转移潜能增强和侵袭性。虽然手术是治疗的基石，但对于未接受手术的患者，相关研究有限。 方法：我们利用监测、流行病学和最终结果（SEER）数据库（1975 - 2019年）的数据，对非手术治疗的MPBC患者进行了回顾性分析。此外，从成都市第三人民医院、重庆医科大学附属第一医院和重庆大学附属肿瘤医院招募非手术治疗的MPBC患者，组成临床验证队列（2010 - 2024年）。我们收集了人口统计学和临床数据，包括年龄、种族、婚姻状况、肿瘤位置和治疗方式等。主要终点是总生存期（OS）和乳腺癌特异性生存期（BCSS）。使用R软件进行统计分析，采用Kaplan - Meier曲线和Cox回归模型进行单因素和多因素分析。 结果：SEER数据库共纳入92例非手术治疗的MPBC患者。大多数患者年龄≥60岁（65.22%），为白人（76.09%），单身（64.13%）。肿瘤最常位于上象限（32.61%）。此外，与M0患者相比，M1患者更有可能接受化疗和放疗（50.00%对36.67%；38.46%对13.33%）。Cox回归分析确定化疗和M分期为显著的预后因素。生存分析表明，化疗显著改善了总生存期和乳腺癌特异性生存期（P<0.001），而放疗对生存无显著影响（P>0.05）。在30例非手术治疗的MPBC患者的临床队列中，Kaplan - Meier曲线表明化疗显著延长了患者生存期（P = 0.039），而放疗对生存未显示出显著效果（P = 0.309）。 结论：对于未接受手术的MPBC患者，化疗显著延长生存期，突出了其在治疗中的关键作用。
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