Comparison of outcomes between metaplastic and triple-negative breast cancer patients

Praveen Polamraju, Waqar Haque, Kevin Cao, Vivek Verma, Mary Schwartz, V. Suzanne Klimberg, Sandra Hatch, Polly Niravath, E. Brian Butler, Bin S. Teh

Research output: Contribution to journalArticle

Abstract

Purpose: Metaplastic breast cancer (MBC) is a rare, aggressive variant of breast cancer that has been associated with poor clinical outcomes, as has triple-negative breast (TNBC) cancer. Limited studies compare the clinical characteristics and prognosis of MBC to TNBC. This study uses a large, contemporary US cancer database to compare clinical characteristics and survival outcomes for patients with MBC to those with TNBC. Methods: The National Cancer Database was queried for women with cT1-4N1-3M0 MBC or TNBC diagnosed between 2004 and 2013 and treated with definitive surgery. Chi-squared analysis was performed to determine differences between the cohorts. Kaplan-Meier curves compared overall survival (OS), and Cox regression determined patient factors associated with OS. Results: Altogether, 55,847 patients met the inclusion criteria; 50,705 (90.8%) had TNBC and 5,142 (9.2%) had MBC. Most patients had no comorbid conditions (82%), N0 disease (71%), poorly differentiated histology (77%), received chemotherapy (87%), and received radiation therapy (60%). Amongst all patients, patients with TNBC disease were observed to have greater OS than those with MBC (5-year OS 72.0% vs 55.8%, p < 0.001). The greater observed OS for patients with TNBC persisted when controlling for stage and when comparing propensity score matched cohorts. On Cox regression, lower age, T1 status, N0 status, chemotherapy, TNBC disease, and radiation therapy (RT) were associated with improved OS. Conclusions: MBC had an association with poorer OS compared to TNBC, while RT and chemotherapy receipt were associated with improved OS for patients regardless of stage. Further studies are needed to corroborate the conclusions herein.

Original languageEnglish (US)
Pages (from-to)8-16
Number of pages9
JournalBreast
Volume49
DOIs
StatePublished - Feb 2020

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Triple Negative Breast Neoplasms
Breast Neoplasms
Survival
Radiotherapy
Drug Therapy
Databases
Propensity Score
Neoplasms
Histology

Keywords

  • Breast cancer
  • Chemotherapy
  • Metaplastic
  • Radiation therapy
  • Triple-negative

ASJC Scopus subject areas

  • Surgery

Cite this

Polamraju, P., Haque, W., Cao, K., Verma, V., Schwartz, M., Klimberg, V. S., ... Teh, B. S. (2020). Comparison of outcomes between metaplastic and triple-negative breast cancer patients. Breast, 49, 8-16. https://doi.org/10.1016/j.breast.2019.10.003

Comparison of outcomes between metaplastic and triple-negative breast cancer patients. / Polamraju, Praveen; Haque, Waqar; Cao, Kevin; Verma, Vivek; Schwartz, Mary; Klimberg, V. Suzanne; Hatch, Sandra; Niravath, Polly; Butler, E. Brian; Teh, Bin S.

In: Breast, Vol. 49, 02.2020, p. 8-16.

Research output: Contribution to journalArticle

Polamraju, P, Haque, W, Cao, K, Verma, V, Schwartz, M, Klimberg, VS, Hatch, S, Niravath, P, Butler, EB & Teh, BS 2020, 'Comparison of outcomes between metaplastic and triple-negative breast cancer patients', Breast, vol. 49, pp. 8-16. https://doi.org/10.1016/j.breast.2019.10.003
Polamraju P, Haque W, Cao K, Verma V, Schwartz M, Klimberg VS et al. Comparison of outcomes between metaplastic and triple-negative breast cancer patients. Breast. 2020 Feb;49:8-16. https://doi.org/10.1016/j.breast.2019.10.003
Polamraju, Praveen ; Haque, Waqar ; Cao, Kevin ; Verma, Vivek ; Schwartz, Mary ; Klimberg, V. Suzanne ; Hatch, Sandra ; Niravath, Polly ; Butler, E. Brian ; Teh, Bin S. / Comparison of outcomes between metaplastic and triple-negative breast cancer patients. In: Breast. 2020 ; Vol. 49. pp. 8-16.
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abstract = "Purpose: Metaplastic breast cancer (MBC) is a rare, aggressive variant of breast cancer that has been associated with poor clinical outcomes, as has triple-negative breast (TNBC) cancer. Limited studies compare the clinical characteristics and prognosis of MBC to TNBC. This study uses a large, contemporary US cancer database to compare clinical characteristics and survival outcomes for patients with MBC to those with TNBC. Methods: The National Cancer Database was queried for women with cT1-4N1-3M0 MBC or TNBC diagnosed between 2004 and 2013 and treated with definitive surgery. Chi-squared analysis was performed to determine differences between the cohorts. Kaplan-Meier curves compared overall survival (OS), and Cox regression determined patient factors associated with OS. Results: Altogether, 55,847 patients met the inclusion criteria; 50,705 (90.8{\%}) had TNBC and 5,142 (9.2{\%}) had MBC. Most patients had no comorbid conditions (82{\%}), N0 disease (71{\%}), poorly differentiated histology (77{\%}), received chemotherapy (87{\%}), and received radiation therapy (60{\%}). Amongst all patients, patients with TNBC disease were observed to have greater OS than those with MBC (5-year OS 72.0{\%} vs 55.8{\%}, p < 0.001). The greater observed OS for patients with TNBC persisted when controlling for stage and when comparing propensity score matched cohorts. On Cox regression, lower age, T1 status, N0 status, chemotherapy, TNBC disease, and radiation therapy (RT) were associated with improved OS. Conclusions: MBC had an association with poorer OS compared to TNBC, while RT and chemotherapy receipt were associated with improved OS for patients regardless of stage. Further studies are needed to corroborate the conclusions herein.",
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AU - Polamraju, Praveen

AU - Haque, Waqar

AU - Cao, Kevin

AU - Verma, Vivek

AU - Schwartz, Mary

AU - Klimberg, V. Suzanne

AU - Hatch, Sandra

AU - Niravath, Polly

AU - Butler, E. Brian

AU - Teh, Bin S.

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N2 - Purpose: Metaplastic breast cancer (MBC) is a rare, aggressive variant of breast cancer that has been associated with poor clinical outcomes, as has triple-negative breast (TNBC) cancer. Limited studies compare the clinical characteristics and prognosis of MBC to TNBC. This study uses a large, contemporary US cancer database to compare clinical characteristics and survival outcomes for patients with MBC to those with TNBC. Methods: The National Cancer Database was queried for women with cT1-4N1-3M0 MBC or TNBC diagnosed between 2004 and 2013 and treated with definitive surgery. Chi-squared analysis was performed to determine differences between the cohorts. Kaplan-Meier curves compared overall survival (OS), and Cox regression determined patient factors associated with OS. Results: Altogether, 55,847 patients met the inclusion criteria; 50,705 (90.8%) had TNBC and 5,142 (9.2%) had MBC. Most patients had no comorbid conditions (82%), N0 disease (71%), poorly differentiated histology (77%), received chemotherapy (87%), and received radiation therapy (60%). Amongst all patients, patients with TNBC disease were observed to have greater OS than those with MBC (5-year OS 72.0% vs 55.8%, p < 0.001). The greater observed OS for patients with TNBC persisted when controlling for stage and when comparing propensity score matched cohorts. On Cox regression, lower age, T1 status, N0 status, chemotherapy, TNBC disease, and radiation therapy (RT) were associated with improved OS. Conclusions: MBC had an association with poorer OS compared to TNBC, while RT and chemotherapy receipt were associated with improved OS for patients regardless of stage. Further studies are needed to corroborate the conclusions herein.

AB - Purpose: Metaplastic breast cancer (MBC) is a rare, aggressive variant of breast cancer that has been associated with poor clinical outcomes, as has triple-negative breast (TNBC) cancer. Limited studies compare the clinical characteristics and prognosis of MBC to TNBC. This study uses a large, contemporary US cancer database to compare clinical characteristics and survival outcomes for patients with MBC to those with TNBC. Methods: The National Cancer Database was queried for women with cT1-4N1-3M0 MBC or TNBC diagnosed between 2004 and 2013 and treated with definitive surgery. Chi-squared analysis was performed to determine differences between the cohorts. Kaplan-Meier curves compared overall survival (OS), and Cox regression determined patient factors associated with OS. Results: Altogether, 55,847 patients met the inclusion criteria; 50,705 (90.8%) had TNBC and 5,142 (9.2%) had MBC. Most patients had no comorbid conditions (82%), N0 disease (71%), poorly differentiated histology (77%), received chemotherapy (87%), and received radiation therapy (60%). Amongst all patients, patients with TNBC disease were observed to have greater OS than those with MBC (5-year OS 72.0% vs 55.8%, p < 0.001). The greater observed OS for patients with TNBC persisted when controlling for stage and when comparing propensity score matched cohorts. On Cox regression, lower age, T1 status, N0 status, chemotherapy, TNBC disease, and radiation therapy (RT) were associated with improved OS. Conclusions: MBC had an association with poorer OS compared to TNBC, while RT and chemotherapy receipt were associated with improved OS for patients regardless of stage. Further studies are needed to corroborate the conclusions herein.

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KW - Metaplastic

KW - Radiation therapy

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