背景:化生乳腺癌(MBC)是一种罕见且异质的乳腺癌亚型,我们对其长期结果的理解存在重大差距。这项回顾性队列研究旨在通过仔细检查MBC的病理和临床方面来解决这些差距,以增强临床决策并完善患者护理策略。
方法:这项基于注册的回顾性队列研究包括年龄≥21岁的女性,诊断为MBC或基质产生癌。这些数据是从2001年1月至2020年8月从XXXX的XXXX登记处获得的,其中包括23,935名患者。人口统计学和临床病理特征,新辅助化疗反应,并对生存结局进行分析。统计评估涉及单变量和多变量Cox比例风险模型和Kaplan-Meier生存分析。
结果:本研究共纳入170例患者,其中87.1%患有非转移性疾病,12.9%患有转移性疾病。诊断时患者的年龄为46至65岁(中位数,56年)。队列的主要特征是晚期临床阶段(77.6%),节点消极性(67.6%),3级疾病(74.1%)。在接受治愈性治疗的患者中,新辅助化疗的病理完全缓解率为19.2%,疾病进展率为46.2%.多因素分析显示,辅助放疗显著提高了总生存期(OS)和无病生存期(DFS),风险比(HR)为0.29(95%置信区间[CI],0.13-0.62;p<0.005)和0.23(95%CI,0.10-0.50;p<0.005),分别。临床T3和T4阶段,淋巴结参与与不良结局相关。新辅助化疗后病情稳定与OS和DFS差相关。
结论:本研究揭示了MBC的复杂景观,并强调了辅助放疗在提高患者预后方面的关键作用。尽管取得了进步,挑战依然存在,需要继续进行研究,以完善新辅助化疗策略,并深入研究影响治疗反应的细微因素.
OBJECTIVE: Metaplastic breast cancer (MBC) is a rare and heterogeneous breast cancer subtype, and there are critical gaps in our understanding of its long-term outcomes. This retrospective cohort study aimed to address these gaps by scrutinizing the pathologic and clinical aspects of MBC to enhance clinical decision-making and refine patient care strategies.
METHODS: This registry-based retrospective cohort study included women aged ≥21 years diagnosed with MBC or matrix-producing carcinoma. The data were obtained from January 2001 to August 2020 from the Joint Breast Cancer Registry of Singapore Health Services, which included 23,935 patients. Demographic and clinicopathologic characteristics, neoadjuvant chemotherapy responses, and survival outcomes were analyzed. Statistical assessments involved univariate and multivariate Cox proportional hazards models and Kaplan-Meier survival analyses.
RESULTS: This study enrolled 170 patients; 87.1% had non-metastatic disease, and 12.9% had metastatic disease. The age of patients at diagnosis ranged from 46 to 65 years (median, 56 years). The cohort\'s predominant characteristics were triple negative breast cancer (64%), advanced clinical stage (77.6%), node negativity (67.6%), and grade 3 disease (74.1%). In patients receiving neoadjuvant chemotherapy with curative intent treatment (17.6%), neoadjuvant chemotherapy yielded a pathologic complete response of 19.2% and a disease progression rate of 46.2%. Multivariate analysis showed that adjuvant radiation therapy significantly improved overall survival and disease-free survival, with hazard ratios of 0.29 (95% CI, 0.13-0.62; P < .005) and 0.23 (95% CI, 0.10-0.50; P < .005), respectively. Clinical T3 and T4 stages and nodal involvement were associated with poor outcomes. Stable disease after neoadjuvant chemotherapy was associated with poor overall survival and disease-free survival.
CONCLUSIONS: This study sheds light on the complex landscape of MBC and emphasizes the pivotal role of adjuvant radiation therapy in enhancing patient outcomes. Despite advancements, challenges persist that warrant continued research to refine neoadjuvant chemotherapy strategies and delve into the nuanced factors that influence treatment responses.