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Survival Outcomes of Metaplastic Breast Cancer Patients: Results from a US Population-based Analysis

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Metaplastic breast cancer (MBC) is a rare histologic subtype needing further characterization. The aim of our study was to compare MBC to infiltrating ductal carcinoma (IDC) of the breast and to identify demographic, clinicopathologic, treatment, and survival differences.

Methods

MBC and IDC patients were identified using the Surveillance, Epidemiology, and End Results (SEER) public-use data set. Disease-specific survival (DSS) differences were compared using the Kaplan–Meier method and log-rank tests. Univariate and multivariate Cox proportional hazard models were used to assess factors prognostic for DSS. To control for hormone receptor status, a subsequent planned analysis was completed for receptor-negative MBC and IDC. Lastly, a matched case-control analysis was conducted to minimize potential bias due to baseline demographic, clinical, and pathologic differences.

Results

The SEER data set included 1,011 MBC and 253,818 IDC patients diagnosed from 2001 to 2010. MBC patients had larger, higher grade tumors, had less frequent axillary nodal involvement, and were more likely to be treated with mastectomy. Five-year DSS rates were significantly worse for patients with MBC than for IDC patients (78 vs. 93 %, p < 0.0001) and for patients with receptor-negative MBC than receptor-negative IDC (77 vs. 85 %, p < 0.0001). The findings were confirmed on matched analysis. Prognostic factors identified on multivariate analyses included age, MBC histology, tumor grade, T stage, and axillary lymph node involvement.

Conclusions

MBC patients have shorter DSS than IDC patients. Improved clinical and biological understanding of MBC may result in more effective therapy and better cancer outcomes.

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Acknowledgment

The authors would like to thank Nicola Solomon, PhD, for her editorial contribution. The data and analyses contained in this manuscript have been presented in part at the Society of Surgical Oncology 2012 Annual Meeting.

Disclosure

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Biostatistics, City of Hope National Medical Center, Duarte, CA, USA

    Rebecca A. Nelson PhD

  2. Division of Surgical Oncology, City of Hope National Medical Center, Duarte, CA, USA

    Mary L. Guye MD & Lily L. Lai MD

  3. Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA

    Thehang Luu MD

Authors
  1. Rebecca A. Nelson PhD
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  2. Mary L. Guye MD
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  3. Thehang Luu MD
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  4. Lily L. Lai MD
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Corresponding author

Correspondence to Lily L. Lai MD.

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Nelson, R.A., Guye, M.L., Luu, T. et al. Survival Outcomes of Metaplastic Breast Cancer Patients: Results from a US Population-based Analysis. Ann Surg Oncol 22, 24–31 (2015). https://doi.org/10.1245/s10434-014-3890-4

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  • DOI: https://doi.org/10.1245/s10434-014-3890-4

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