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Unique Characteristics and Failure Patterns of Metaplastic Breast Cancer in Contrast to Invasive Ductal Carcinoma: A Retrospective Multicenter Case-Control Study (KROG 13-07)

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Author(s)
김진희조지형
Alternative Author(s)
Kim, Jin HeeCho, Ji Hyoung
Publication Year
2015
Abstract
In this retrospective multicenter study, a comparison of metaplastic breast cancer (MBC) patients with exactly
matched patients with invasive ductal carcinoma (IDC) showed that MBC is associated with a greater incidence
of triple negativity, poor differentiation, and a greater recurrence rate. The locoregional and systemic
management might be modified in MBC.
Background: This retrospective study was performed to investigate the need for management modification in MBC
according to evaluation of characteristics and failure patterns compared with IDC. Patients and Methods: We performed
this multicenter study taking MBC and randomly assigned IDC cases matched for age ( 3 years), pathologic
stage (T and N), locoregional treatment methods (surgery with or without radiation therapy), and period of treatment
( 6 months) that occurred from January 1999 to November 2011 in the 6 institutions of the Korean Radiation
Oncology Group. Results: A total of 144 female MBC patients were enrolled. The median follow-up was 51 months
(range, 1-186 months). The rates of positivity for estrogen receptor (P < .001), progesterone receptor (P < .001), and
HER2 (P ¼ .007) were significantly lower in MBC patients. During follow-up, recurrence developed in 22 (15.3%) MBC
and 6 (4.2%) IDC patients (P ¼ .002). The median time to recurrence of MBC and IDC was 15 months and 24 months,
respectively. Most instances of recurrence in MBC developed in the triple-negative (TN) subgroup (TN-MBC). In
particular, locoregional recurrence developed exclusively in the TN-MBC subgroup. In the TN-MBC subgroup, the
number of risk factors (pT2-3, N1-3) was related to significant differences in overall survival (P ¼ .001) and recurrencefree
survival (P < .001). Conclusion: The MBC patients had a higher rate of TN, poorer differentiation, and a higher
recurrence rate than did the IDC patients. Considering the unique characteristics and failure patterns, it is necessary
to modify the current management guidelines for MBC.
Department
Dept. of Radiation Oncology (방사선종양학)
Dept. of Surgery (외과학)
Publisher
School of Medicine
Citation
Clinical Breast Cancer, Vol.15(2) : e105-115, 2015
Type
Article
ISSN
1526-8209
DOI
10.1016/j.clbc.2014.10.002
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/35440
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