Abstract:
Objective: To investigate the clinicopathologic characteristics and prognostic factors of metaplastic breast cancer (MBC). MBC prognosis was compared with that of triple negative breast cancer (TNBC). Methods:This retrospective study reviewed the medical records of 55MBC patients who underwent surgery in Tianjin Medical University Cancer Institute and Hospital between January 2005and January 2015. Clinicopathological features and different therapeutic strategies were analyzed. Univariate and multi -variate analyses were conducted to identify prognostic factors. Based on nodal status, the MBC patients were divided into node positive (N+) and node negative (N 0) groups. According to specific treatment conditions, such as chemotherapy, radiation therapy (RT), and en-docrine therapy, MBC patients were divided into adjuvant chemotherapy and non- adjuvant chemotherapy groups, RT and non- RT groups, and endocrine therapy and non-endocrine therapy groups. Each MBC case, which had complete follow-up data, was compared with three TNBC cases that were used as controls in the same database and matched with age, year of diagnosis, and tumor-node-metas-tasis staging. Results: Five- year disease- free survival (DFS) rate of MBC cases was 45.0% . Overall survival (OS) rate was48.2% . These results were worse than those of TNBC cases, in which the five- year DFS and OS rates were 74.7% and 83.5% , respectively. MBC and TNBC cases exhibited significant differences in both rates. Survival analysis showed that large tumor size, lymph node metas-tasis, and adjuvant chemotherapy were correlated with worse prognosis. Adjuvant chemotherapy significantly improved OS (P=0.008) and DFS rates (P=0.033) of patients. RT significantly improved the five-year OS (P=0.030) in MBC patients with node metastasis.Con -clusion: MBC is a clinically aggressive subtype of breast cancers, and its prognosis was worse compared with TNBC. Adjuvant chemotherapy may be recommended, and cisplatin- based chemotherapy regimen may be an effective therapeutic regimen for several MBC subtypes. For MBC patients with N+, RT should be a multimodality therapy component.