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Metaplastic breast cancer: clinicopathological features and its prognosis

Authors
 Hyewon Lee  ;  So-Youn Jung  ;  Jae Yun Ro  ;  Youngmee Kwon  ;  Joo Hyuk Sohn  ;  In Hae Park  ;  Keun Seok Lee  ;  Seeyoun Lee  ;  Seok Won Kim  ;  Han Sung Kang  ;  Kyoung Lan Ko  ;  Jungsil Ro 
Citation
 JOURNAL OF CLINICAL PATHOLOGY, Vol.65(5) : 441-446, 2012 
Journal Title
JOURNAL OF CLINICAL PATHOLOGY
ISSN
 0021-9746 
Issue Date
2012
MeSH
Biomarkers, Tumor/analysis ; Breast/pathology* ; Breast Neoplasms/chemistry ; Breast Neoplasms/drug therapy ; Breast Neoplasms/mortality ; Breast Neoplasms/pathology* ; Carcinoma, Ductal, Breast/chemistry ; Carcinoma, Ductal, Breast/drug therapy ; Carcinoma, Ductal, Breast/mortality ; Carcinoma, Ductal, Breast/secondary* ; Disease-Free Survival ; Female ; Humans ; Lymph Nodes/pathology ; Mastectomy, Segmental/methods ; Metaplasia ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Receptor, ErbB-2/analysis ; Receptors, Estrogen/analysis ; Receptors, Progesterone/analysis ; Republic of Korea/epidemiology ; Survival Rate
Keywords
Biomarkers, Tumor/analysis ; Breast/pathology* ; Breast Neoplasms/chemistry ; Breast Neoplasms/drug therapy ; Breast Neoplasms/mortality ; Breast Neoplasms/pathology* ; Carcinoma, Ductal, Breast/chemistry ; Carcinoma, Ductal, Breast/drug therapy ; Carcinoma, Ductal, Breast/mortality ; Carcinoma, Ductal, Breast/secondary* ; Disease-Free Survival ; Female ; Humans ; Lymph Nodes/pathology ; Mastectomy, Segmental/methods ; Metaplasia ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Receptor, ErbB-2/analysis ; Receptors, Estrogen/analysis ; Receptors, Progesterone/analysis ; Republic of Korea/epidemiology ; Survival Rate
Abstract
AIMS:
The prognosis of metaplastic breast cancer (MBC) is reportedly worse than that of triple-negative invasive ductal carcinoma (TN-IDC), but the determinants of poor prognosis are not yet known.
METHODS:
Patients from two Korean cancer centres were included in this study (67 MBC and 520 TN-IDC). Characteristics of the two disease groups, including clinical parameters, histological features, chemoresponsiveness, disease recurrence and survival estimates, were evaluated.
RESULTS:
MBC presented with larger tumours, more frequent distant metastasis and higher histological grade compared with TN-IDC (p<0.001). All but nine patients with MBC had triple-negative disease. Disease-free survival and overall survival (OS) of MBC were worse than TN-IDC (p<0.001). Multivariable analysis of disease-free survival revealed MBC type as an independent prognostic factor (HR 2.53; 95% CI 1.32 to 4.84) along with lymph node metastasis and implementation of breast conserving surgery. For OS, MBC type remained a significant prognostic factor (HR 2.56; 95% CI 1.18 to 5.54). Chemoresponsiveness of MBC and TN-IDC were similar in both neoadjuvant (p=1.000) and advanced disease settings (p=0.508). For a given MBC type, risk factors for disease recurrence included the presence of a squamous component (HR 4.0; 95% CI 1.46 to 10.99) and lymph node metastasis (HR 4.76; 95% CI 1.67 to 13.60); the risk factor for OS was initial distant metastasis (HR 10.77; 95% CI 2.59 to 44.76).
CONCLUSIONS:
MBC had worse survival outcomes compared with TN-IDC. Poor prognosis for MBC was likely caused by frequent recurrence with high initial stage and the unique biology of MBC itself.
Full Text
http://jcp.bmj.com/content/65/5/441.long
DOI
22412048
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Sohn, Joo Hyuk(손주혁) ORCID logo https://orcid.org/0000-0002-2303-2764
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90703
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