Survival outcomes of metaplastic breast carcinoma: An Indian tertiary care center data.

e12579 Background: Metaplastic breast carcinoma is a rare histological subtype that has basal like characteristics and is reported to have a poorer prognosis than no specific type/ductal carcinoma (ductal/NST). We aimed to investigate clinicopathological features and outcome from a single institution based registry. Methods: Clinical records of breast cancer patients treated during 2012-2019 were screened and 31 cases of metaplastic breast carcinoma were found. Descriptive analysis was done for patients’ demographics and clinicopathological features. Kaplan Meier method was used to assess survival outcomes. Results: The incidence of metaplastic breast cancer was 0.5% (31/6180) in our study out of which the most common histopathological differentiation was squamous (45.16%). The second most common was sarcomatoid histology (32.25%), followed by chondroid (9.68%) and mixed histology (12.9%). The median age at diagnosis was 60 years ranging from 28 to 82 years. 64.15% of patients were post-menopausal. At presentation, three (9.67%) patients had metastatic disease while the rest were diagnosed with early (51.61%) and locally advanced cancers (38.72%). Triple negative cancers (ER/PR/Her2 negative) constituted the vast majority with 22 cases (80.6%) while hormone receptor positive (ER/PR positive, Her-2 negative) and Her-2 neu positive (ER/PR negative) made up the rest with three patients (9.67%) each group respectively. The median overall survival was found to be 39 months (95% CI 25.46 - 52.53). Conclusions: After a thorough search in PubMed and Google Scholar, we could not find a larger case series from India with clinical outcomes for metaplastic breast carcinoma. Our results suggest that metaplastic breast carcinoma is a heterogenous disease. Outcomes of metaplastic breast carcinoma are relatively worse when compared with literature for triple negative breast cancer and breast cancer in general. Further biological understanding may offer valuable insights for newer targets and therapeutic approaches to metaplastic breast cancer.

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New Developments in Breast Cancer Prognosis: Molecular Predictors of Treatment Response and Survival

The International Journal of Biological Markers ◽

10.5301/jbm.5000027 ◽

2013 ◽

Vol 28 (2) ◽

pp. 131-140 ◽

Cited By ~ 3

Author(s):

Eleanor MN Foo ◽

Maureen V Boost ◽

Anthony SW Wong ◽

Wings TY Loo ◽

Louis WC Chow ◽

...

Keyword(s):

Breast Cancer ◽

Triple Negative ◽

Disease Free Survival ◽

Clinicopathological Features ◽

Cancer Prognosis ◽

Rank Test ◽

Survival Outcomes ◽

Luminal A ◽

Luminal B ◽

Her 2

Aim This study aimed to assess the molecular subtypes of breast cancer for patients attending a dedicated breast care center and examine the association with clinicopathological features, treatment and survival outcomes. Methods Demographic, clinicopathological and treatment details were collected from women with primary breast cancer. Immunohistochemical subtypes were also collected. The association between breast cancer subtypes and clinicopathological features was assessed using the chi-square or Fisher's exact test. Survival outcomes were compared among subtypes with the log-rank test. Results Immunohistochemical subtypes were not associated with tumor size, lymphovascular invasion or lymph node involvement but differed by histological grade (p=0.014) and nuclear grade of tumors (p=0.001). The 5-year overall survival estimates for luminal A, luminal B, HER-2-positive and triple-negative tumors were 100%, 96.2%, 71.4% and 92.3% respectively. Compared to luminal A tumors (93.4%), luminal B (80.8%), HER-2-positive (71.4%) and triple-negative (76.9%) tumors exhibited a reduced disease-free survival (DFS). Patients with ER-positive tumors had a higher DFS than their ER-negative counterparts (p=0.036). Patients with tumors expressing a low Ki-67 level had a more favorable prognosis (p=0.02). Conclusions The most prevalent luminal A subtype is associated with relatively better prognosis, whereas HER-2-positive and triple-negative tumors are prone to early relapse with diminished survival.

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How shall we treat locally advanced triple negative breast cancer?

F1000Research ◽

10.12688/f1000research.20509.2 ◽

2020 ◽

Vol 8 ◽

pp. 1649

Author(s):

Paulo Luz ◽

David Dias ◽

Ana Fortuna ◽

Luis Bretes ◽

Beatriz Gosalbez

Keyword(s):

Breast Cancer ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Locally Advanced ◽

Surrogate Marker ◽

Metastatic Breast ◽

Complete Response ◽

Number Of Patients ◽

Her 2 ◽

Near Future

Triple negative breast cancer (TNBC) has been shown to respond to neoadjuvant chemotherapy (NACT). It has been established that achieving pathological complete response (pCR) for certain aggressive subtypes of breast cancer, including HER-2 (over-expressed) and TNBC, provides an important surrogate marker for predicting long-term clinical response and survival outcomes. How to increase the number of patients that achieve pCR remains challenging. Platinum-based NACT seems to be part of the solution and capecitabine, an active drug in metastatic breast cancer, but not a standard one in earlier stages may have found its place in the adjuvant setting. In the near future immunotherapy can play a role in early TNBC

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The Clinicopathological Features and Survival Outcomes of Different Histological Subtypes in Triple-negative Breast Cancer

Journal of Cancer ◽

10.7150/jca.22280 ◽

2018 ◽

Vol 9 (2) ◽

pp. 296-303 ◽

Cited By ~ 20

Author(s):

Hong-Ye Liao ◽

Wen-Wen Zhang ◽

Jia-Yuan Sun ◽

Feng-Yan Li ◽

Zhen-Yu He ◽

...

Keyword(s):

Breast Cancer ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Clinicopathological Features ◽

Survival Outcomes ◽

Histological Subtypes

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A retrospective study of inflammatory breast cancer patients from seven hospitals in the United Kingdom.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e11062 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e11062-e11062

Author(s):

Saeed Rafii ◽

Christopher John Poole ◽

Adele Francis ◽

Shalini Chaudhri ◽

Daniel Rea

Keyword(s):

Breast Cancer ◽

United Kingdom ◽

Neoadjuvant Chemotherapy ◽

Cancer Patients ◽

Inflammatory Breast Cancer ◽

Triple Negative ◽

Breast Cancer Patients ◽

The United Kingdom ◽

Her 2 ◽

Clinical Records

e11062 Background: Inflammatory breast cancer (IBC) is an aggressive form of locally advanced breast cancer characterised by rapidly progressive breast erythema, pain and tenderness, oedema and paeu d’orange. It is estimated that between 1-4 % of all newly diagnosed breast cancer patients in the United Kingdom have IBC. Methods: We retrospectively identified 51 patients who were treated for IBC at 7 hospitals in the West midlands area of the United Kingdom between 1997 and 2011. Data including patients’ demographics, clinical, radiological and histopathological characteristics were collected from electronic clinical records. The test for HER-2 over-expression was not carried out routinely before 2002, therefore HER-2 status of such patients were assessed retrospectively on the archived tissues. A cox regression analysis was used for statistical assessment of survival and prognostic factors. Results: Median age at diagnosis was 55 years (range 34-83 yrs). Median overall (OS) and progression free survival (PFS) were 32 months (range 7-97 months) and 27 months (range 2-53 months) respectively. The 3–year survival rate for the entire cohort was 32%. Majority of patients were ER and HER-2 positive (49% and 52% respectively). The rate of complete pathological response (pCR) after neoadjuvant chemotherapy was 14%. All cases who had achieved pCR were HER-2 positive who had received anti HER-2 treatment during the neoadjuvant chemotherapy. The OS for the HER-2 positive patients with pCR was not statistically different from the whole cohort (49 vs 32 months, p=0.09) or from the patients with residual disease (49 vs 26 months, p=0.13). Although the triple negative IBC patients consisted 20% of the cohort, no patients in this group had achieved pCR. The OS and PFS for the triple negative patients were 20 and 14 months respectively. Although the rate of pCR was higher in patients treated with taxane compared to those treated with anthracycline containing chemotherapy (35% vs 7%), there was no significant difference in OS between either of these regimens (29 vs 27 months). Conclusions: HER-2 positive IBC patients had higher rate of achieving pCR after neo-adjuvant anti HER-2 therapy. However higher rate of pCR did not improve the OS.

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Single-institution experience with neoadjuvant chemotherapy for metaplastic breast cancer (MBC).

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.27_suppl.140 ◽

2012 ◽

Vol 30 (27_suppl) ◽

pp. 140-140

Author(s):

Anna Kaminsky

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Neoadjuvant Chemotherapy ◽

Triple Negative Breast Cancer ◽

Tumor Volume ◽

Triple Negative ◽

Volume Reduction ◽

Tumor Volume Reduction ◽

Metaplastic Breast Carcinoma

140 Background: Metaplastic breast carcinoma (MBC) is a rare subtype that accounts for <1% of all breast carcinomas. MBC is frequently triple-negative and neoadjuvant chemotherapy (NAC) is often used in triple-negative breast cancer (TNBC). The objective of this analysis is to ascertain response rates of MBC to NAC as compared to non-metaplastic TNBC. Methods: We searched the Magee Women’s Cancer Center of UPMC IRB-approved neo-adjuvant treatment database which contains outcome data on 594 patients treated from 2004-2010. 116 patients with triple negative breast cancer (ER /PR negative or ER /PR weakly positive [H score of 10 or less] and HER2 negative or indeterminate [HER2 1+ or 2+ without amplification by FISH]), were identified. Nine of these TNBCs had metaplastic subtype and two groups were analyzed: metaplastic breast carcinoma (MBC) (N= 9) and non-metaplastic breast carcinoma (NMBC) (N = 107). Tumor volume reduction (TVR), pathologic complete response (pCR), recurrence and mortality were compared in both groups. Results: Average follow-up in MBC group was 43 months and no patients were lost to follow-up. Average tumor size on presentation in MBC group was 4.47 cm while in NMBC group it was 3.33 cm. pCR was noted in 0/9 MBC and 43/107 NMBC cases (p = 0.0253). 6/9 patients had mastectomy, 2/9 had breast conserving surgery (BCS) and 1/9 patients did not have a surgery yet. Average TVR was 28% in MBC cases compared to 74% in NMBCs when cases with pCR were included (p = 0.0001) and 56% when cases with pCR were excluded (p = 0.0202). Follow up on 9 MBC cases revealed 1 recurrence and subsequent death (11%). Follow-up on 64 NMBC patients who failed to achieve pCR revealed 22 recurrences (34%) and 18 of them subsequently died (28%). Follow-up on 43 NMBC cases that achieved pCR revealed 3 recurrences (7%) and 1 death (2%). Conclusions: MBC was characterized by larger size at baseline as compared to NMBC. There were no pCR’s seen in MBC, but some MBC did achieve response that allowed for breast conservation. Although the average tumor volume reduction was significantly less in MBC compared to NMBC, the NMBC that failed to achieve pCR fared much worse than MBC who did not achieve pCR. Therefore, the triple-negative paradox is likely not applicable to MBC.

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P275 Platinum compounds (PLcs) added to standard adjuvant or neoadjuvant regimen of doxorubicin plus cyclophosphamide (AC), followed by weekly paclitaxel (wP) in triple negative (TN), HER 2-neu positive (HER 2+) or locally advanced breast cancer (LABC)

The Breast ◽

10.1016/s0960-9776(11)70217-x ◽

2011 ◽

Vol 20 ◽

pp. S66

Author(s):

M. Vassilaki ◽

A. Sioulas ◽

M. Tsantekidou ◽

A. Klitsa ◽

N. Desses ◽

...

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Triple Negative ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Advanced Breast ◽

Weekly Paclitaxel ◽

Platinum Compounds ◽

Her 2

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STUDY ON TWO YEAR SURVIVAL OF STAGE II AND STAGE III BREAST CARCINOMA IN EASTERN INDIA WITH SPECIAL REFERANCE TO PROGNOSTIC MARKERS HER-2/NEU, ER, PR AND Ki-67.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i4.1092 ◽

2020 ◽

Vol 4 (4) ◽

Author(s):

Deepika Pandey ◽

Rajesh kumar Sinha ◽

Gautam Mandal

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Breast Carcinoma ◽

Triple Negative ◽

Disease Free Survival ◽

Stage Ii ◽

Stage Iii ◽

Ki 67 ◽

Important Indicator ◽

Her 2

Breast cancer is one of the most commonly diagnosed malignancies and leading cause of cancer death in women over the world and the second most common cancer in females in India. Length of survival of cancer patients is an important indicator for knowing the outcome of treatment in any study. As the disease burden and mortality rate is very high, knowing the factors that influence survival rates among women with breast cancer may help design early detection and improve treatment. The immunohistochemistry plays a very important role in prognostication and treatment determination. Aim: This study aims to correlate the various relevant prognostic pattern like reactivity pattern of ER,PR,Her-2/Neu ,ki-67 and 2-yr overall survival. Material and method: The proposed study was a cross sectional study with mostly prospective observation and with some retrospective observation, included 74 patients of stage II and stage III breast carcinoma who underwent MRM in Chittaranjan National Cancer Institute from 2017-2018. The various clinical and histopathological prognostic parameters with Estrogen/ Progesterone hormone receptors and Human epidermal growth factor receptor (Her-2/Neu) status in invasive breast carcinoma patients were studied and correlated. Result: 58.1%, 54.1% and 35.1% of the cases were ER, PR and Her-2/neu positive respectively. 89.2% of cases had Ki-67 level >20%. Her-2 neu negative, ER negative and KI-67>20% were found to be significant factors for mortality. Maximum (66.7%) of patients with recurrence and maximum (53.8%) patients who died in study period had triple negative breast cancer. Triple negative tumours have poor survival as compared to ER + PR + and HER-2/Neu +ve tumours. Disease free survival and overall survival of the patients with Ki-67< 20% was better than that of patients with Ki-67>20% (100%). Keywords: Breast cancer, Invasive ductal carcinoma, ER,PR,HER-2/Neu , Ki-67 , Two year survival.

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Single institution experience with neoadjuvant chemotherapy for metaplastic breast cancer (MBC).

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.1038 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 1038-1038 ◽

Cited By ~ 1

Author(s):

Anna Kaminsky ◽

Rohit Bhargava ◽

Kandace P McGuire ◽

Shannon Puhalla

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Neoadjuvant Chemotherapy ◽

Triple Negative Breast Cancer ◽

Tumor Volume ◽

Triple Negative ◽

Volume Reduction ◽

Tumor Volume Reduction ◽

Metaplastic Breast Carcinoma

1038 Background: Metaplastic breast carcinoma (MBC) is a rare subtype that accounts for <1% of all breast carcinomas. MBC is frequently triple negative and neoadjuvant chemotherapy (NAC) is often used in triple negative breast cancer (TNBC). The objective of this analysis is to ascertain response rates of MBC to NAC as compared to non-metaplastic TNBC. Methods: We searched the Magee Women’s Cancer Center of UPMC IRB-approved neo-adjuvant treatment database which contains outcome data on 594 patients treated from 2004-2010. 116 patients with triple negative breast cancer (ER /PR negative or ER /PR weakly positive (H score of 10 or less) and HER2 negative or indeterminate (HER2 1+ or 2+ without amplification by FISH)), were identified. Nine of these TNBCs had metaplastic subtype and 2 groups were analyzed: metaplastic breast carcinoma (MBC) (N= 9) and non-metaplastic breast carcinoma (NMBC) (N = 107). Tumor volume reduction (TVR), pathologic complete response (pCR), recurrence and mortality were compared in both groups. Results: Mean follow up in MBC group was 43 months and no patients were lost to follow up. Mean tumor size on presentation in MBC group was 4.47 cm while in NMBC group it was 3.33 cm. pCR was noted in 0/9 MBC and 43/107 NMBC cases (p = 0.0253). 6/9 patients had mastectomy, 2/9 had breast conserving surgery (BCS) and 1/9 patients did not have a surgery yet. Average TVR was 28% in MBC cases compared to 74% in NMBCs when cases with pCR were included (p = 0.0001) and 56% when cases with pCR were excluded (p = 0.0202). Follow up on 9 MBC cases revealed 1 recurrence and subsequent death (11%). Follow up on 64 NMBC patients who failed to achieve pCR revealed 22 recurrences (34%) and 18 of them subsequently died (28%).Follow up on 43 NMBC cases that achieved pCR revealed 3 recurrences (7%) and 1 death (2%). Conclusions: MBC was characterized by larger size at baseline as compared to NMBC. There were no pCR’s seen in MBC, but some MBC did achieve response that allowed for breast conservation. Although the average tumor volume reduction was significantly less in MBC compared to NMBC, the NMBC that failed to achieve pCR fared much worse than MBC who did not achieve pCR. Therefore, the triple negative paradox is likely not applicable to MBC.

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