Metaplastic breast cancer: Prognostic and therapeutic considerations.

Autor: Corso G; Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy.; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy., Frassoni S; Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy., Girardi A; Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy., De Camilli E; Division of Pathology, European Institute of Oncology, IRCCS, Milan, Italy., Montagna E; Division of Breast Cancer Medical Treatments, European Institute of Oncology, IRCCS, Milan, Italy., Intra M; Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy., Bottiglieri L; Division of Pathology, European Institute of Oncology, IRCCS, Milan, Italy., Margherita De Scalzi A; Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy., Fanianos DM; Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy., Magnoni F; Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy., Invento A; Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy., Toesca A; Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy., Conforti F; Division of Medical Oncology for Melanoma, Sarcoma, and Rare Tumors, European Institute of Oncology, IRCCS, Milan, Italy., Bagnardi V; Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy., Viale G; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.; Division of Pathology, European Institute of Oncology, IRCCS, Milan, Italy., Colleoni MA; Division of Breast Cancer Medical Treatments, European Institute of Oncology, IRCCS, Milan, Italy., Veronesi P; Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy.; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2021 Jan; Vol. 123 (1), pp. 61-70. Date of Electronic Publication: 2020 Oct 12.
DOI: 10.1002/jso.26248
Abstrakt: Introduction: Metaplastic breast cancer (MBC) is a rare condition of breast tumor with different subtypes, considered a disease with worse prognosis; treatments and survival are often unclear and conflicting.
Methods: We consecutively collected 153 primary MBCs of different subtypes. Breast surgery, neoadjuvant or adjuvant treatment, clinic-pathological factors, number and type of events during follow-up were considered to evaluate overall survival (OS) and invasive disease-free survival (IDFS).
Results: The majority of MBC was triple-negative (TN) subtype (88.7%), G3 (95.3%), pN0 (70.6%), and with high levels of Ki-67 (93.5%). For OS and IDFS, no significant associations were seen between the different MBC subtypes. The matched triple-negative MBC (TNMBC) and ductal TNBC cohorts had similar prognosis both in terms of OS (p = .411) and IDFS (p = .981). We observed a positive trend for TNMBC patients treated in the adjuvant setting with the cyclofosfamide, methotrexate, 5-fluorouracil protocol for better OS (p = .090) and IDFS (p = .087). A poor or absent response rate was observed in the neoadjuvant setting.
Conclusion: Our results demonstrate that metaplastic and ductal breast cancers with TN phenotype are similar in terms of overall and disease-free survival. Metaplastic cancers are poorly responsive to neoadjuvant treatment, and in the absence of novel targeted therapies, surgical treatment remains the first choice.
(© 2020 Wiley Periodicals LLC.)
Databáze: MEDLINE
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