Abstract P1-12-03: Metaplastic carcinoma of the breast: A single-center 18-year series of 73 cases
Notice bibliographique
Résumé
Abstract Background: Metaplastic breast cancer (MeBC) is a rare subtype accounting for 0.2%-5% of all invasive breast cancer. They are characterized by an aggressive course and even a worse prognosis than triple-negative breast cancer (TNBC). The literature suggests that MeBCs are relatively chemoresistant; still, the patients often receive adjuvant or neoadjuvant chemotherapy during the course of treatment. This study aimed to examine the clinical management of MeBC, particularly the role of chemotherapy. Methods: This retrospective study included patients with MeBC (n=73) from the Centre des Maladies du Sein du CHU de Québec-Université Laval. The specimens were reviewed by two pathologists. Patient and tumor characteristics, systemic therapy (neoadjuvant and adjuvant), disease-free survival (DFS), and overall survival (OS) were recorded. Results: The median follow-up was 57.2 months. The mean tumor size was 39.5±32.1 (range, 1-200) mm. The vast majority had grade 3 (76.7%), no evidence of clinical nodal involvement (78.1%), and triple-negative (79.5%) disease. This population included one case (1.4%) of low-grade adenosquamous breast carcinoma, one (1.4%) of fibromatosis-like metaplastic carcinoma, 11 (15.1%) of spindle cell carcinoma, 13 (17.8%) of epidermoid carcinoma, 18 (24.7%) of MeBC with heterologous mesenchymal differentiation, and 29 (39.7%) of mixed MeBC. Chemotherapy was given to 53 (72.6%) patients. Thirty-seven patients (50.7%) had a lumpectomy, and 34/37 (91.9%) received adjuvant radiotherapy. Thirty-six patients (49.3%) had mastectomy and 22/36 (61.1%) received radiotherapy. The 5-year DFS was 55.6%, and the 5-year OS was 63.5 %. On univariable analyses, higher cT stage (cT3-4) was associated with poorer DFS and OS compared to cT1-2, respectively 13.4% vs. 70.7% (P<0.0001) and 19.9% vs. 82.8% (P<0.0001). Nodal involvement significantly influenced DFS (31.3% vs. 63.0%, P=0.011) and OS (37.5% vs. 71.6%; P=0.009). Lumpectomy was associated with a better 5-year DFS (78.4% vs. 34.0%, P<0.0001) and OS (90.6% vs. 38.8%, P<0.0001). The use of chemotherapy had a significant positive effect on 5-year DFS (64.2% vs. 31.9%, P=0.006; hazard ratio (HR)=0.45, 95% confidence interval (CI)=0.22-0.92, P=0.009) as well as 5-year OS (69.7% vs. 45.1%, P=0.035; HR=0.52, 95%CI=0.28-0.95 P=0.041). However, radiation therapy did not influence DFS (P=0.420) and OS (P=0.316). Nine patients received neoadjuvant chemotherapy; five had nodal involvement. One patient had a complete response (11.1%), five (55.6%) had a partial response, and three (33%) had progressive disease. The 5-year DFS and OS were lower for neoadjuvant chemotherapy compared with adjuvant chemotherapy (DFS: 27.8% vs. 71.5%, P=0.006; OS: 33.3% vs. 79.2%, P=0.001), but disease was more advanced in patients with neoadjuvant chemotherapy (cT3-4: 88.9% vs. 11.9%, P<0.0001). Conclusion: MeBC represents a rare heterogeneous group of malignancies with poor prognosis. Chemotherapy was associated with improved DFS and OS. Patients for neoadjuvant chemotherapy should be carefully selected. Citation Format: Kassandra J Thériault, Mariem Ben Moussa, Marjorie Perron, Christine Desbiens, Brigitte Poirier, Éric Poirier, Dominique Leblanc, Claudya Morin, Julie Lemieux, Jean-Charles Hogue, Dominique Boudreau. Metaplastic carcinoma of the breast: A single-center 18-year series of 73 cases [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-12-03.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».