Scholarlink

Background <p>This study analyzed a large national cohort to compare treatment strategies and survival outcomes in metaplastic breast cancer (MtBC), a rare and aggressive subtype with poor treatment response.</p> Patients and Methods <p>Adult female patients with MtBC diagnosed between 2006 and 2021 were identified from the National Cancer Database and grouped by chemotherapy sequence (neoadjuvant vs. adjuvant) to evaluate clinical characteristics and survival outcomes.</p> Results <p>Among 9526 patients, 30.1% received neoadjuvant and 69.9% adjuvant chemotherapy. The cohort was predominantly white (76.7%) and non-Hispanic (90.8%), with a median age of 60 years; most had a comorbidity score of 0 (81%). Neoadjuvant therapy use increased from 14.3 to 43.9% and was more common among younger patients with advanced clinical stages. The immunotherapy administration grew from 0 to 23.95%. Over a mean follow-up of 69 months, 5-year overall survival was higher in the adjuvant group (80.7% vs. 66.7%). In multivariable analysis, adjuvant therapy was associated with improved overall survival [hazard ratio (HR) 0.65; 95% CI 0.54–0.72; <i>p</i> &lt; 0.001]. Mastectomy, radiation, and higher income level were also linked to improved outcomes, while older age, nodal involvement, comorbidities, and lymphovascular invasion were associated with higher mortality.</p> Conclusions <p>Adjuvant chemotherapy and aggressive local treatments were associated with improved survival, supporting a tailored approach that includes upfront surgery followed by adjuvant therapy as a potentially optimal strategy for operable cases. Meanwhile, the increasing use of neoadjuvant chemotherapy has coincided with rising survival rates, and the integration of immunotherapy into neoadjuvant regimens is also promising, highlighting the need for future studies.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Neoadjuvant Versus Adjuvant Therapy for Metaplastic Breast Cancer: Insights from the National Cancer Database—Is There a Winning Strategy?

  • 期刊论文

  • 发表日期：

    2025年9月10日

查看全文
  • Fatemeh Shojaeian,
  • Mahtab Vasigh,
  • Haydee del Calvo,
  • Lourdes G. Chaves,
  • Miranda R. Jones,
  • Cesar Santa-Maria,
  • Gayatri Nimmagadda,
  • Olutayo Sogunro

摘要

Background

This study analyzed a large national cohort to compare treatment strategies and survival outcomes in metaplastic breast cancer (MtBC), a rare and aggressive subtype with poor treatment response.

Patients and Methods

Adult female patients with MtBC diagnosed between 2006 and 2021 were identified from the National Cancer Database and grouped by chemotherapy sequence (neoadjuvant vs. adjuvant) to evaluate clinical characteristics and survival outcomes.

Results

Among 9526 patients, 30.1% received neoadjuvant and 69.9% adjuvant chemotherapy. The cohort was predominantly white (76.7%) and non-Hispanic (90.8%), with a median age of 60 years; most had a comorbidity score of 0 (81%). Neoadjuvant therapy use increased from 14.3 to 43.9% and was more common among younger patients with advanced clinical stages. The immunotherapy administration grew from 0 to 23.95%. Over a mean follow-up of 69 months, 5-year overall survival was higher in the adjuvant group (80.7% vs. 66.7%). In multivariable analysis, adjuvant therapy was associated with improved overall survival [hazard ratio (HR) 0.65; 95% CI 0.54–0.72; p < 0.001]. Mastectomy, radiation, and higher income level were also linked to improved outcomes, while older age, nodal involvement, comorbidities, and lymphovascular invasion were associated with higher mortality.

Conclusions

Adjuvant chemotherapy and aggressive local treatments were associated with improved survival, supporting a tailored approach that includes upfront surgery followed by adjuvant therapy as a potentially optimal strategy for operable cases. Meanwhile, the increasing use of neoadjuvant chemotherapy has coincided with rising survival rates, and the integration of immunotherapy into neoadjuvant regimens is also promising, highlighting the need for future studies.