Does treatment sequence affect outcomes in patients with metaplastic breast cancer?

• Published in: The American journal of surgery Vol. 221; no. 4; pp. 701 - 705
• Main Authors: Ladipo, Oluwatomi L., Ren, Yi, Caddell, Keenan B., Sampathkumar, Anuyuga, Almond, Chandra A., Fayanju, Oluwadamilola M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2021; Elsevier Limited
• Subjects: Adjuvant; Adult; Age; Age Factors; Aged; Breast cancer; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Cancer therapies; Chemotherapy; Chemotherapy, Adjuvant; Combined Modality Therapy; Female; Hispanic people; Histology; Humans; Kaplan-Meier Estimate; Medical prognosis; Metaplastic; Middle Aged; Mutation; Neoadjuvant; Neoadjuvant Therapy; Neoplasm Metastasis; Neoplasm Staging; Patients; Prognosis; Radiation; Radiotherapy, Adjuvant; Rank tests; Survival; Treatment sequence; Neoadjuvant; Metaplastic; Chemotherapy; Breast cancer; Adjuvant; Treatment sequence
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2021.01.007

We compared characteristics and outcomes by treatment sequence among patients with metaplastic breast cancer (MBC), an aggressive subtype.
Women ≥18 years old with newly diagnosed Stage I-III MBC from 2003 to 2018 who received any treatment in our health system were identified. Unadjusted overall survival (OS) was estimated with the Kaplan-Meier method; the log-rank test was used to compare survival differences between recipients of neoadjuvant (NACT) and adjuvant chemotherapy (ACT).
Of the 91 MBC patients identified, 60 received chemotherapy. NACT recipients (n = 20, median age 46.5 y) were younger than ACT recipients (n = 40, median age 60.5 y, p < 0.001) but similar with regards to race and radiation receipt. There was no significant OS difference between NACT and ACT recipients (log-rank p = 0.15), which remained true when patients were stratified by age (≥50 y vs < 50 y).
Among MBC patients, NACT recipients were younger than ACT recipients, but there was no survival difference by treatment sequence.
In our study of metaplastic breast cancer (MBC), an aggressive subtype:Most MBC patients received neoadjuvant (NACT) or adjuvant chemotherapy (ACT).NACT recipients were younger than ACT recipients.NACT and ACT recipients were similar with regards to race and radiation receipt.MBC patients had similar survival regardless of treatment sequence.