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 machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
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 source (Gemma direct ou Codex distillé), 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 ».