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Japanese Journal of Clinical Oncology Advance Access published online on November 3, 2009
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyp139
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© The Author (2009). Published by Oxford University Press. All rights reserved

Metaplastic Breast Carcinoma: Clinicopathologic Features and Prognostic Value of Triple Negativity

Kyu-Hyoung Lim1, Do-Youn Oh1,2, Eui Kyu Chie3, Wonshik Han4, Seock-Ah Im1,2, Tae-You Kim1,2, In Ae Park5, Dong-Young Noh4, Sung Whan Ha3 and Yung-Jue Bang1,2

1 Department of Internal Medicine, Seoul National University College of Medicine
2 Cancer Research Institute, Seoul National University College of Medicine
3 Department of Radiation Oncology, Seoul National University College of Medicine
4 Department of Surgery, Seoul National University College of Medicine
5 Department of Pathology, Seoul National University College of Medicine, Seoul, Korea

For reprints and all correspondence: Do-Youn Oh, Department of Internal Medicine, Seoul National University Hospital, 28 Yongondong, Chongno-gu, Seoul 110-744, Korea. E-mail: ohdoyoun{at}snu.ac.kr

Received March 29, 2009; accepted September 15, 2009

Objective: Metaplastic breast carcinomas (MBC) are a rare type of breast cancer and are generally characterized by hormone receptor and human epidermal growth factor receptor 2 (HER2) negativity. There is a paucity of information on prognosis according to hormone receptor and HER2 expression for these rare tumors. The aim of this study was to compare the clinical features and prognosis between triple-negative metaplastic carcinoma (TNMC) and non-triple-negative metaplastic carcinoma (NTNMC).

Methods: We retrospectively analyzed MBC patients treated at Seoul National University Hospital between 1996 and 2006. The medical records were reviewed.

Results: Fifty-one patients were identified. At a median follow-up of 40.8 months, the 3-year disease-free survival (DFS) and overall survival (OS) rates were 75.5% and 86.3%, respectively. Non-triple negativity (P = 0.012) correlated significantly with OS in multivariate analysis. Of the 51 patients, 41 (80.4%) had TNMC and 10 (19.6%) had NTNMC. The two groups did not differ significantly by age, tumor size or nodal status. In patients with NTNMC, the positivity rates for estrogen receptor, progesterone receptor and HER2 were 20.0%, 30.0% and 80.0% in NTNMC. The 3-year OS rates in patients with TNMC and NTNMC were 93.4% and 58.2%, respectively (P = 0.007). With respect to DFS, there was no statistically significant difference between patients with TNMC and those with NTNMC (P = 0.149).

Conclusions: In MBC, the non-triple-negative group had a poor prognosis compared with the triple-negative group, which is contrary to what has been reported in patients with invasive ductal carcinoma of breast. Further research exploring the mechanism underlying this result is needed.

Key Words: metaplastic breast carcinoma • prognosis • triple negative


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