Metaplastic carcinoma of the breast: real-world outcome from a tertiary cancer centre in India

14 Jul 2022
Balasubramanian Ananthi, Priya Iyer, Rama Ranganathan, Kanchan Murhekar, Manikandan Dhanushkodi, Selvaluxmy Ganesarajah, Sridevi Velusami, Arvind Krishnamurthy

Metaplastic carcinoma (MPC) is a rare subgroup of breast tumours accounting for <5% of all invasive breast cancers. Histologically confirmed 40 MPC from January 2001 to December 2018 were identified from our electronic database: stage I 2.5% (n = 1), stage II 40% (n = 16), stage III 45% (n = 18) and stage IV 12.5% (n = 5). The mean tumour size was 6 cm, node-negative in 60%, and hormone receptor-negative in 75%. Among the 35 non-metastatic patients, 17 (48.6%) received initial neoadjuvant treatment (NAT), followed by surgery, and only 1 had a complete pathological response. At a median follow-up of 60 months, 17% (n = 6) had a recurrence. All six of them had lung metastasis. The 5-year overall survival (OS) and disease-free survival were 64.4% and 66.3%, respectively. Age more than 46 years (p = 0.027), tumour size more than 5 cm (p = 0.037), and nodal positivity (p = 0.001) were predictors of OS. In node-positive patients, the 5-year OS in those who underwent initial surgery was 80% and after NAT was 21.4% (p = 0.069). In node-negative patients, the 5-year OS after initial surgery was 83.3% and after NAT was 90% (p = 0.380). A statistical significance could not be demonstrated due to the small number of patients. Due to chemoresistance, the concept of initial NAT in MPC of the breast is a subject to be studied in the future. Upfront surgery should be considered for operable diseases (including stage III), followed by a decision on adjuvant therapy. Optimal treatment and effective systemic therapy regimens are yet to be defined

Related Articles

Josepmilly del Valle Peña Colmenares, Carmen Cristina García, Yazmin José Velásquez Velásquez, Leider Arelis Campos Pino, Álvaro Gómez Rodríguez, Wladimir José Villegas Rodríguez, David José González Vargas, Douglas José Angulo Herrera
Josepmilly del Valle Peña Colmenares, Yazmin José Velásquez Velásquez, Wladimir José Villegas Rodríguez, Leider Arelis Campos Pino, Álvaro Gómez Rodríguez, Douglas José Angulo Herrera
João Henrique Fonseca do Nascimento, Cleonice Nascimento da Silva, André Gusmão-Cunha, Marinho Marques Silva Neto, André Bouzas de Andrade
Homian N’da Marcelin, Romuald S Dasse, Richard O Yeboah, Agnès D Tariam, Arsène G Z Kagambega, Akandji M Oseni, YKK Kouassi, Michel A Bilé, Moctar Toure, Monica Thakar, Innocent Adoubi, Darya Kizub