Chemotherapy significantly improves long-term survival of small lesion node negative metaplastic breast carcinoma in T1c population rather than T1a and T1b

Qitong Chen,Yunchang Yuan,Qiongyan Zou,Hongye He,Wenjun Yi,Qin Zhou,Yeqing He

doi:10.1038/s41598-022-04946-0

Qitong Chen, Yunchang Yuan + Show 5 more

Open Access

https://doi.org/10.1038/s41598-022-04946-0

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Abstract

Metaplastic breast carcinoma (MpBC) is considered a highly aggressive disease, the outcome of chemotherapy on small lesions (T1abcN0M0) MpBC patients remain unclear. We identified 890 female MpBC patients in the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2016. After propensity score matching (PSM), 584 patients were matched. Survival probability was compared among T1a, T1b, and T1c patients and between patients with and without chemotherapy using Kaplan–Meier analysis and Cox proportional hazard analysis. Significance was set at two-sided P < 0.05. We classified 49, 166, and 675 patients as T1a, T1b, and T1c MpBC, respectively. The chemotherapy group included 404 patients (45.4%). Following PSM, survival analysis indicated that the patients who underwent chemotherapy had higher OS (P = 0.0002) and BCSS (P = 0.0276) in the T1c substage, but no significant difference was detected in T1a or T1b patients. In this population-based study, small lesion MpBC showed a favorable prognosis. Chemotherapy improved the prognosis of T1c MpBC patients but not T1a and T1b patients to a beneficial extent. Our findings may offer novel insight into a therapeutic strategy for MpBC.

Highlights

Metaplastic breast carcinoma (MpBC) is considered a highly aggressive disease, the outcome of chemotherapy on small lesions (T1abcN0M0) MpBC patients remain unclear
Chemotherapy is an essential component of breast cancer therapy; there is little evidence to support that standard breast cancer chemotherapy regimens utilized for invasive ductal carcinoma (IDC) are effective for women with MpBC
We aimed to explore and identify the survival benefit of chemotherapy in MpBC patients based on data from the Surveillance, Epidemiology, and End Results (SEER) d atabase[8]

Summary

Introduction

Metaplastic breast carcinoma (MpBC) is considered a highly aggressive disease, the outcome of chemotherapy on small lesions (T1abcN0M0) MpBC patients remain unclear. Following PSM, survival analysis indicated that the patients who underwent chemotherapy had higher OS (P = 0.0002) and BCSS (P = 0.0276) in the T1c substage, but no significant difference was detected in T1a or T1b patients. In this population-based study, small lesion MpBC showed a favorable prognosis. Previous reports suggest that MpBC tends to be aggressive and has an inferior prognosis[3] The efficacy of chemotherapy for MpBC, especially for small mass lesions (T1a [1–5 mm], T1b [5–10 mm], T1c [10–20 mm] stage) and lymph nodenegative, remains unclear

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