Metaplastic breast cancer

Prognosis and response to systemic therapy

D. Rayson, Alex Adjei, Vera Jean Suman, L. E. Wold, J. N. Ingle

Research output: Contribution to journalArticle

134 Citations (Scopus)

Abstract

Background: Metaplastic breast cancer is a rare disease with little information available to guide therapy. The goals of this study were to describe the patient characteristics, systemic therapies and clinical outcomes of all patients with primary metaplastic breast cancer treated at Mayo Clinic between 1976 and 1997. Patients and methods: Patients were identified through the medical index of Mayo Clinic. Clinical information was abstracted from the medical record of each patient. A literature search using MEDLINE and CANCERLIT for the years 1966-1997 was performed to identify all previously reported case series in the English language containing 10 or more patients. Results: Twenty-seven patients were identified with a median age at diagnosis of 59 years (range 39-90 years). The median tumor size was 3.4 cm (range 0.5-7.0 cm). One patient had metastatic disease at presentation. Twenty-three patients had information available on nodal status, estrogen receptor (ER) and progesterone receptor (PR) status. Twenty patients (87%) were node-negative and three patients (13%) were both ER and PR positive. Disease-free survival (DFS) and overall survival (OS) were assessed for those who presented with local-regional disease. The three-year DFS was 40% (95% CI: 23%-73%) and the three-year OS was 71% (95% CI: 51%-97%). In univariate analysis, those patients 60 years of age or older at diagnosis were found to have an increased DFS (P = 0.011). Among those with prior estrogen use, both DFS (P = 0.022) and OS (P = 0.003) were decreased. Thirteen patients (50%) developed metastases with a median DFS time of 2.4 years. Ten different chemotherapy regimens were utilized for metastatic disease and one partial response was observed. There were no responses to tamoxifen in four patients with metastatic disease. Median survival after the development of metastases was eight months. Conclusions: Despite presenting more commonly as node- negative disease, DFS and OS in metaplastic breast cancer is decreased compared to typical adenocarcinomas. Systemic therapy also appears to be less effective. Patients with metaplastic breast cancer, particularly those with metastatic disease could be appropriate candidates for innovative therapeutic regimens.

Original languageEnglish (US)
Pages (from-to)413-419
Number of pages7
JournalAnnals of Oncology
Volume10
Issue number4
DOIs
StatePublished - 1999

Fingerprint

Breast Neoplasms
Disease-Free Survival
Therapeutics
Survival
Progesterone Receptors
Estrogen Receptors
Neoplasm Metastasis
Tamoxifen
Rare Diseases
MEDLINE
Medical Records
Estrogens
Adenocarcinoma
Language
Drug Therapy

Keywords

  • Metaplastic breast cancer
  • Prognosis
  • Systemic therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Metaplastic breast cancer : Prognosis and response to systemic therapy. / Rayson, D.; Adjei, Alex; Suman, Vera Jean; Wold, L. E.; Ingle, J. N.

In: Annals of Oncology, Vol. 10, No. 4, 1999, p. 413-419.

Research output: Contribution to journalArticle

Rayson, D. ; Adjei, Alex ; Suman, Vera Jean ; Wold, L. E. ; Ingle, J. N. / Metaplastic breast cancer : Prognosis and response to systemic therapy. In: Annals of Oncology. 1999 ; Vol. 10, No. 4. pp. 413-419.
@article{357cf1ba724b41b3a48efb7920d3c325,
title = "Metaplastic breast cancer: Prognosis and response to systemic therapy",
abstract = "Background: Metaplastic breast cancer is a rare disease with little information available to guide therapy. The goals of this study were to describe the patient characteristics, systemic therapies and clinical outcomes of all patients with primary metaplastic breast cancer treated at Mayo Clinic between 1976 and 1997. Patients and methods: Patients were identified through the medical index of Mayo Clinic. Clinical information was abstracted from the medical record of each patient. A literature search using MEDLINE and CANCERLIT for the years 1966-1997 was performed to identify all previously reported case series in the English language containing 10 or more patients. Results: Twenty-seven patients were identified with a median age at diagnosis of 59 years (range 39-90 years). The median tumor size was 3.4 cm (range 0.5-7.0 cm). One patient had metastatic disease at presentation. Twenty-three patients had information available on nodal status, estrogen receptor (ER) and progesterone receptor (PR) status. Twenty patients (87{\%}) were node-negative and three patients (13{\%}) were both ER and PR positive. Disease-free survival (DFS) and overall survival (OS) were assessed for those who presented with local-regional disease. The three-year DFS was 40{\%} (95{\%} CI: 23{\%}-73{\%}) and the three-year OS was 71{\%} (95{\%} CI: 51{\%}-97{\%}). In univariate analysis, those patients 60 years of age or older at diagnosis were found to have an increased DFS (P = 0.011). Among those with prior estrogen use, both DFS (P = 0.022) and OS (P = 0.003) were decreased. Thirteen patients (50{\%}) developed metastases with a median DFS time of 2.4 years. Ten different chemotherapy regimens were utilized for metastatic disease and one partial response was observed. There were no responses to tamoxifen in four patients with metastatic disease. Median survival after the development of metastases was eight months. Conclusions: Despite presenting more commonly as node- negative disease, DFS and OS in metaplastic breast cancer is decreased compared to typical adenocarcinomas. Systemic therapy also appears to be less effective. Patients with metaplastic breast cancer, particularly those with metastatic disease could be appropriate candidates for innovative therapeutic regimens.",
keywords = "Metaplastic breast cancer, Prognosis, Systemic therapy",
author = "D. Rayson and Alex Adjei and Suman, {Vera Jean} and Wold, {L. E.} and Ingle, {J. N.}",
year = "1999",
doi = "10.1023/A:1008329910362",
language = "English (US)",
volume = "10",
pages = "413--419",
journal = "Annals of Oncology",
issn = "0923-7534",
publisher = "Oxford University Press",
number = "4",

}

TY - JOUR

T1 - Metaplastic breast cancer

T2 - Prognosis and response to systemic therapy

AU - Rayson, D.

AU - Adjei, Alex

AU - Suman, Vera Jean

AU - Wold, L. E.

AU - Ingle, J. N.

PY - 1999

Y1 - 1999

N2 - Background: Metaplastic breast cancer is a rare disease with little information available to guide therapy. The goals of this study were to describe the patient characteristics, systemic therapies and clinical outcomes of all patients with primary metaplastic breast cancer treated at Mayo Clinic between 1976 and 1997. Patients and methods: Patients were identified through the medical index of Mayo Clinic. Clinical information was abstracted from the medical record of each patient. A literature search using MEDLINE and CANCERLIT for the years 1966-1997 was performed to identify all previously reported case series in the English language containing 10 or more patients. Results: Twenty-seven patients were identified with a median age at diagnosis of 59 years (range 39-90 years). The median tumor size was 3.4 cm (range 0.5-7.0 cm). One patient had metastatic disease at presentation. Twenty-three patients had information available on nodal status, estrogen receptor (ER) and progesterone receptor (PR) status. Twenty patients (87%) were node-negative and three patients (13%) were both ER and PR positive. Disease-free survival (DFS) and overall survival (OS) were assessed for those who presented with local-regional disease. The three-year DFS was 40% (95% CI: 23%-73%) and the three-year OS was 71% (95% CI: 51%-97%). In univariate analysis, those patients 60 years of age or older at diagnosis were found to have an increased DFS (P = 0.011). Among those with prior estrogen use, both DFS (P = 0.022) and OS (P = 0.003) were decreased. Thirteen patients (50%) developed metastases with a median DFS time of 2.4 years. Ten different chemotherapy regimens were utilized for metastatic disease and one partial response was observed. There were no responses to tamoxifen in four patients with metastatic disease. Median survival after the development of metastases was eight months. Conclusions: Despite presenting more commonly as node- negative disease, DFS and OS in metaplastic breast cancer is decreased compared to typical adenocarcinomas. Systemic therapy also appears to be less effective. Patients with metaplastic breast cancer, particularly those with metastatic disease could be appropriate candidates for innovative therapeutic regimens.

AB - Background: Metaplastic breast cancer is a rare disease with little information available to guide therapy. The goals of this study were to describe the patient characteristics, systemic therapies and clinical outcomes of all patients with primary metaplastic breast cancer treated at Mayo Clinic between 1976 and 1997. Patients and methods: Patients were identified through the medical index of Mayo Clinic. Clinical information was abstracted from the medical record of each patient. A literature search using MEDLINE and CANCERLIT for the years 1966-1997 was performed to identify all previously reported case series in the English language containing 10 or more patients. Results: Twenty-seven patients were identified with a median age at diagnosis of 59 years (range 39-90 years). The median tumor size was 3.4 cm (range 0.5-7.0 cm). One patient had metastatic disease at presentation. Twenty-three patients had information available on nodal status, estrogen receptor (ER) and progesterone receptor (PR) status. Twenty patients (87%) were node-negative and three patients (13%) were both ER and PR positive. Disease-free survival (DFS) and overall survival (OS) were assessed for those who presented with local-regional disease. The three-year DFS was 40% (95% CI: 23%-73%) and the three-year OS was 71% (95% CI: 51%-97%). In univariate analysis, those patients 60 years of age or older at diagnosis were found to have an increased DFS (P = 0.011). Among those with prior estrogen use, both DFS (P = 0.022) and OS (P = 0.003) were decreased. Thirteen patients (50%) developed metastases with a median DFS time of 2.4 years. Ten different chemotherapy regimens were utilized for metastatic disease and one partial response was observed. There were no responses to tamoxifen in four patients with metastatic disease. Median survival after the development of metastases was eight months. Conclusions: Despite presenting more commonly as node- negative disease, DFS and OS in metaplastic breast cancer is decreased compared to typical adenocarcinomas. Systemic therapy also appears to be less effective. Patients with metaplastic breast cancer, particularly those with metastatic disease could be appropriate candidates for innovative therapeutic regimens.

KW - Metaplastic breast cancer

KW - Prognosis

KW - Systemic therapy

UR - http://www.scopus.com/inward/record.url?scp=0032961242&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032961242&partnerID=8YFLogxK

U2 - 10.1023/A:1008329910362

DO - 10.1023/A:1008329910362

M3 - Article

VL - 10

SP - 413

EP - 419

JO - Annals of Oncology

JF - Annals of Oncology

SN - 0923-7534

IS - 4

ER -