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Metaplastic carcinoma of the breast: matched cohort analysis of recurrence and survival

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Abstract

Purpose

Metaplastic breast carcinoma (MBC) is a rare subtype of breast cancer, defined as mammary carcinoma with squamous or mesenchymal differentiation, that may include spindle cell, chondroid, osseous, or rhabdomyoid differentiation patterns. The implications of MBC recurrence and survival outcomes remains unclear.

Methods

Cases were ascertained from a prospectively maintained institutional database of patients treated from 1998 to 2015. Patients with MBC were matched 1:1 to non-MBC cases. Cox proportional-hazards models and Kaplan–Meier estimates were used to evaluate outcome differences between cohorts.

Results

111 patients with MBC were matched 1:1 with non-MBC patients from an initial set of 2400 patients. Median follow-up time was 8 years. Most patients with MBC received chemotherapy (88%) and radiotherapy (71%). On univariate competing risk regression, MBC was not associated with locoregional recurrence (HR = 1.08; p = 0.8), distant recurrence (HR = 1.65; p = 0.092); disease-free survival (HR = 1.52; p = 0.065), or overall survival (HR = 1.56; p = 0.1). Absolute differences were noted in 8-year disease-free survival (49.6% MBC vs 66.4% non-MBC) and overall survival (61.3% MBC vs 74.4% non-MBC), though neither of these reached statistical significance (p = 0.07 and 0.11, respectively).

Conclusion

Appropriately-treated MBC may exhibit recurrence and survival outcomes that are difficult to distinguish from those of non-MBC. While prior studies suggest that MBC has a worse natural history than non-MBC triple-negative breast cancer, prudent use of chemotherapy and radiotherapy may narrow these differences, although studies with more power will be required to inform clinical management. Longer follow-up among larger populations may further elucidate the clinical and therapeutic implications of MBC.

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Data availability

Enquiries about data availability should be directed to the authors.

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Acknowledgements

The authors would like to acknowledge Anthony Abaya and Michael Sullivan for support with data management. This study was supported in part by the Lois Green Fund and NIH/NCI Cancer Center support grant P30CA008748.

Funding

This study was supported in part by the Lois Green Fund and NIH/NCI Cancer Center Support Grant No. P30CA008748.

Author information

Authors and Affiliations

  1. Weill Cornell Medical College, New York, NY, USA

    Priyanka Narayan

  2. Departments of Biostatistic and Epidemiology, New York, NY, USA

    Caroline E. Kostrzewa & Zhigang Zhang

  3. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, Box 22, New York, NY, 10065, USA

    Diana A. Roth O’Brien, Boris A. Mueller, John J. Cuaron, Amy J. Xu, Michael B. Bernstein, Beryl McCormick, Simon N. Powell, Atif J. Khan & Lior Z. Braunstein

  4. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Hannah Y. Wen

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  1. Priyanka Narayan
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  13. Lior Z. Braunstein
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Correspondence to Lior Z. Braunstein.

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Narayan, P., Kostrzewa, C.E., Zhang, Z. et al. Metaplastic carcinoma of the breast: matched cohort analysis of recurrence and survival. Breast Cancer Res Treat 199, 355–361 (2023). https://doi.org/10.1007/s10549-023-06923-1

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  • DOI: https://doi.org/10.1007/s10549-023-06923-1

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