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Similar rates of disease-free and overall survival were seen in a study of women with metaplastic and ductal triple-negative breast cancer (TNBC), according to an Italian study presented at the 17th St. Gallen International Breast Cancer Conference.
According to the study poster, metaplastic breast carcinoma accounts for 0.2% to 0.5% of all breast cancers and has an aggressive clinical evolution. In this study, Antonia Girardi, of the division of breast surgery at the European Institute of Oncology IRCCS, in Milan, Italy, and colleagues evaluated if metaplastic breast cancer had a clinical evolution, treatment, overall survival, and prognosis that matched a population of patients with TNBC.
The retrospective study included data from all cases of metaplastic breast cancer in the institutional database at the European Institute of Oncology in Milan. All cases diagnosed between 1998 and 2019 were included in the study.
The majority of metaplastic cases were triple negative (88.7%). Additionally, most cases were grade 3 (95.3%), pN0 (70.6%), with peritumoral vascular invasion (89.3%), and with high levels of Ki-67 (93.5%).
The overall survival at 3 years for metaplastic cases was 86.1%. The researchers identified 49/153 relapses that were either distant or locoregional. The 3-year invasive disease-free survival was 74.6%.
Metaplastic and ductal TNBC were found to have similar prognosis for overall survival and invasive disease-free survival. Metaplastic disease treated in the adjuvant setting with cyclophosphamide, methotrexate, and 5-fluorouracil was associated with a positive trend for better overall survival (P =.09) and invasive disease-free survival (P =.087).
However, the researchers noted, “metaplastic cancers are poorly responsive to neoadjuvant treatment, and in the absence of novel targeted therapies, surgical treatment remains the first choice.”
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Giradi A, Magnoni F, Corso G, Veronesi P. Is metaplastic breast cancer more aggressive than “classic” triple-negative ductal carcinoma? Recent prognostic and therapeutic consideration. Poster presented at: 17th St. Gallen International Breast Cancer Conference; March 17-21, 2021. Abstract P165.