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<p>This study aimed to evaluate the prognostic impact of adjuvant and neoadjuvant chemotherapy (ACT, NACT) in high-grade triple-negative metaplastic breast cancer (TNMBC) and to compare survival outcomes with those of triple-negative breast cancer of no special type (TNBC NST). A total of 73 patients with high-grade TNMBC and 369 patients with TNBC NST were included in the study. In the non-NACT and ACT subgroups, TNMBC patients exhibited significantly worse overall survival (OS), distant disease-free survival (DDFS), breast cancer-specific survival (BCSS), and disease-free survival (DFS) than TNBC NST patients (non-NACT: <i>p</i> &lt; 0.001 for all endpoints; ACT: OS, <i>p</i> &lt; 0.001; DDFS, <i>p</i> &lt; 0.001; BCSS, <i>p</i> = 0.004; DFS, <i>p</i> &lt; 0.001). In the NACT subgroup, TNMBC and TNBC NST patients had similar survival outcomes. Within the TNMBC cohort, patients treated with NACT without achieving a pathological complete response (pCR) demonstrated improved OS (<i>p</i> = 0.045) and a trend toward improved BCSS (<i>p</i> = 0.056) compared to TNMBC patients who did not receive CT. No significant survival difference was observed between TNMBC patients treated with ACT and those without CT, nor between NACT-treated TNMBC patients without a pCR and those treated with ACT. We conclude that survival outcomes of TNMBC vs. TNBC NST patients may be influenced by systemic treatment. NACT-treated TNMBC patients without a pCR demonstrated superior OS compared to TNMBC patients receiving no CT, while no survival difference was observed among TNMBC patients based on treatment sequencing (ACT vs. NACT).</p>

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Survival outcomes after systemic treatment of high-grade triple-negative metaplastic breast cancer versus triple-negative breast cancer of no special type

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月22日

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  • Claudia Grosse,
  • Alexandra Grosse,
  • Heike Kathleen Schwarz,
  • Heike Frauchiger-Heuer,
  • Tamara Rordorf,
  • Alexander Ring,
  • Rupert Langer,
  • Zsuzsanna Varga

摘要

This study aimed to evaluate the prognostic impact of adjuvant and neoadjuvant chemotherapy (ACT, NACT) in high-grade triple-negative metaplastic breast cancer (TNMBC) and to compare survival outcomes with those of triple-negative breast cancer of no special type (TNBC NST). A total of 73 patients with high-grade TNMBC and 369 patients with TNBC NST were included in the study. In the non-NACT and ACT subgroups, TNMBC patients exhibited significantly worse overall survival (OS), distant disease-free survival (DDFS), breast cancer-specific survival (BCSS), and disease-free survival (DFS) than TNBC NST patients (non-NACT: p < 0.001 for all endpoints; ACT: OS, p < 0.001; DDFS, p < 0.001; BCSS, p = 0.004; DFS, p < 0.001). In the NACT subgroup, TNMBC and TNBC NST patients had similar survival outcomes. Within the TNMBC cohort, patients treated with NACT without achieving a pathological complete response (pCR) demonstrated improved OS (p = 0.045) and a trend toward improved BCSS (p = 0.056) compared to TNMBC patients who did not receive CT. No significant survival difference was observed between TNMBC patients treated with ACT and those without CT, nor between NACT-treated TNMBC patients without a pCR and those treated with ACT. We conclude that survival outcomes of TNMBC vs. TNBC NST patients may be influenced by systemic treatment. NACT-treated TNMBC patients without a pCR demonstrated superior OS compared to TNMBC patients receiving no CT, while no survival difference was observed among TNMBC patients based on treatment sequencing (ACT vs. NACT).