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

Ronald Limón, Lucia Reynolds, Erick Rocha, Lucia Richter, Mario Gianella, Oscar Niño de Guzman, Gerson Mejía, José Nina, Wendy Rojas, Lijia Avilés, Iván Maldonado, Cristian Pacheco, Claudio Martín, Maria G Cervantes, Federico Bakal, Eduardo Cazap
Abhenil Mittal, S V S Deo, Ajay Gogia, Atul Batra, Akash Kumar, Sandeep Bhoriwal, Koushik Sinha Deb, Ekta Dhamija, V L Ramprasad, Olufunmilayo Olopade, Raja Pramanik
Rogério Agenor de Araújo, Felipe Andrés Cordero da Luz, Eduarda da Costa Marinho, Camila Piqui Nascimento, Lara de Andrade Marques, Patrícia Ferreira Ribeiro Delfino, Rafael Mathias Antonioli, Breno Jeha Araújo, Ana Cristina Araújo Lemos da Silva, Maria Luiza Gonçalves dos Reis Monteiro, Morun Bernardino Neto, Marcelo José Barbosa Silva
Tsion Afework, Birtukan Seid, Aderaw Anteneh, Wondimu Ayele, Seifu Hagos Gebreyesus, Bilal Shikur Endris