Prognostic factors in metaplastic carcinoma of the breast: a multi-institutional study

Rakha, E A; Tan, P H; Varga, Z; Tse, G M; Shaaban, A M; Climent, F; van Deurzen, C H M; Purnell, D; Dodwell, D; Ellis, I O; Chan, T

Abstract

Background: Metaplastic breast carcinoma (MBC) is a rare type of breast cancer that has basal-like characteristics and is perceived
to have poorer prognosis when compared with conventional no specific type/ductal carcinomas (ductal/NST). However, current
data on MBC are largely derived from small case series or population-based reports. This study aimed to assess the
clinicopathological features and outcome of MBC identified through an international multicentre collaboration.
Methods: A large international multicentre series of MBC (no ¼ 405) with histological confirmation and follow-up information has
been included in this study. The prognostic value of different variables and outcome has been assessed and compared with
grade, nodal status and ER/HER2 receptor-matched ductal/NST breast carcinoma.
Results: The outcome of MBC diagnosed in Asian countries was more favourable than those in Western countries. The outcome
of MBC is not different from matched ductal/NST carcinoma but the performance of the established prognostic variables in MBC
is different. Lymph node stage, lymphovascular invasion and histologic subtype are associated with outcome but tumour size and
grade are not. Chemotherapy was associated with longer survival, although this effect was limited to early-stage disease. In this
study no association between radiotherapy and outcome was identified. Multivariate analysis of MBC shows that histologic
subtype is an independent prognostic feature.
Conclusions: This study suggests that MBC is a heterogeneous disease. Although the outcome of MBC is not different to
matched conventional ductal/NST breast carcinoma, its behaviour is dependent on the particular subtype with spindle cell
carcinoma in particular has an aggressive biological behaviour. Management of patients with MBC should be based on validated
prognostic variables.

Citation

Rakha, E. A., Tan, P. H., Varga, Z., Tse, G. M., Shaaban, A. M., Climent, F., …Chan, T. (2015). Prognostic factors in metaplastic carcinoma of the breast: a multi-institutional study. British Journal of Cancer, 112(2), 283-289. https://doi.org/10.1038/bjc.2014.592

• Journal Article Type: Article
• Acceptance Date: Nov 1, 2014
• Online Publication Date: Nov 25, 2014
• Publication Date: 2015-01
• Deposit Date: Nov 20, 2018
• Publicly Available Date: Mar 20, 2019
• Journal: British Journal of Cancer
• Print ISSN: 0007-0920
• Electronic ISSN: 1532-1827
• Publisher: Cancer Research UK
• Peer Reviewed: Peer Reviewed
• Volume: 112
• Issue: 2
• Pages: 283-289
• DOI: https://doi.org/10.1038/bjc.2014.592
• Keywords: breast cancer; metaplastic carcinoma; prognosis; outcome; race; tumour type; grade
• Public URL: https://nottingham-repository.worktribe.com/output/1288195