These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Early and Locally Advanced Metaplastic Breast Cancer: Presentation and Survival by Receptor Status in Surveillance, Epidemiology, and End Results (SEER) 2010-2014.
    Author: Schroeder MC, Rastogi P, Geyer CE, Miller LD, Thomas A.
    Journal: Oncologist; 2018 Apr; 23(4):481-488. PubMed ID: 29330212.
    Abstract:
    BACKGROUND: Metaplastic breast cancer (MBC) is a rare disease subtype characterized by an aggressive clinical course. MBC is commonly triple negative (TN), although hormone receptor (HR) positive and human epidermal growth receptor 2 (HER2) positive cases do occur. Previous studies have reported similar outcomes for MBC with regard to HR status. Less is known about outcomes for HER2 positive MBC. MATERIALS AND METHODS: Surveillance, Epidemiology, and End Results Program data were used to identify women diagnosed 2010-2014 with MBC or invasive ductal carcinoma (IDC). Kaplan-Meier curves estimated overall survival (OS) and multivariate Cox models were fitted. For survival analyses, only first cancers were included, and 2014 diagnoses were excluded to allow for sufficient follow-up. RESULTS: Our MBC sample included 1,516 women. Relative to women with IDC, women with MBC were more likely to be older (63 vs. 61 years), black (16.0% vs. 11.1%), and present with stage III disease (15.6% vs. 10.8%). HER2 positive and HER2 negative/HR positive MBC tumors represented 5.2% and 23.0% of cases. For MBC overall, 3-year OS was greatest for women with HER2 positive MBC (91.8%), relative to women with TN (75.4%) and HER2 negative/HR positive MBC (77.1%). This difference was more pronounced for stage III MBC, for which 3-year OS was 92.9%, 47.1%, and 42.2% for women with HER2 positive, TN, and HER2 negative/HR positive MBC, respectively. A multivariate Cox model of MBC demonstrated that HER2 positive tumors (relative to TN) were associated with improved survival (hazard ratio = 0.32, 95% confidence interval [CI] 0.13-0.79). In a second Cox model of exclusively HER2 positive tumors, OS did not differ between MBC and IDC disease subtypes (hazard ratio = 1.16, 95% CI 0.48-2.81). CONCLUSION: In this contemporary, population-based study of women with MBC, HER2 but not HR status was associated with improved survival. Survival was similar between HER2 positive MBC and HER2 positive IDC. This suggests HER2 positive MBC is responsive to HER2-directed therapy, a finding that may offer insights for additional therapeutic approaches to MBC. IMPLICATIONS FOR PRACTICE: This population-based study reports recent outcomes, by receptor status, for women with metaplastic breast cancer. Survival in metaplastic breast cancer is not impacted by hormone receptor status. To the authors' knowledge, this is the first report indicating that women with human epidermal growth receptor 2 (HER2) positive metaplastic breast cancer have survival superior to women with HER2 negative metaplastic breast cancer and survival similar to women with HER2 positive invasive ductal carcinoma. This information can be used for counseling patients diagnosed with metaplastic breast cancer. Further understanding of HER2 positive metaplastic breast cancer could offer insights for the development of therapeutic approaches to metaplastic breast cancer more broadly. 摘要 背景。化生性乳腺癌 (MBC) 是一种以侵袭性临床病程为特征的罕见疾病亚型。MBC 通常呈三阴性 (TN), 但会发生激素受体 (HR) 阳性和人类表皮生长受体 2 (HER2) 阳性病例。既往研究已报告了 MBC 在 HR 状态方面的相似预后。对 HER2 阳性 MBC 的预后知之较少。 材料和方法。使用监测、流行病学和最终结果项目数据识别在 2010 至 2014 年期间诊断出 MBC 或浸润性导管癌 (IDC) 的女性。采用 Kaplan‐Meier 曲线估算总生存率 (OS), 并拟合多变量 Cox 模型。对于生存率分析, 仅将先发癌症包括在内, 并排除了 2014 年的诊断以便进行充分随访。 结果。我们的 MBC 样本包括 1 516 名女性。与 IDC 女性相比, MBC 女性更可能如下所述：年龄较大（63 岁 vs. 61 岁）、黑色人种 (16.0% vs. 11.1%) 以及患有 III 期疾病 (15.6% vs. 10.8%)。HER2 阳性和 HER2 阴性/HR 阳性 MBC 肿瘤占病例的 5.2% 和 23.0%。对于 MBC 总体, 相对于 TN (75.4%) 和 HER2 阴性/HR 阳性 MBC (77.1%) 女性, HER2 阳性 MBC 女性的 3 年 OS 最高 (91.8%)。对于 III 期 MBC, 此差异更为明显, 其中 HER2 阳性、TN 以及 HER2 阴性/HR 阳性 MBC 女性的 3 年 OS 分别为 92.9%、47.1% 和 42.2%。MBC 的多变量 Cox 模型表明, HER2 阳性肿瘤（相对于 TN）与生存率改善有关[风险比=0.32, 95% 置信区间（CI）0.13‐0.79]。在另一个仅针对 HER2 阳性肿瘤的 Cox 模型中, OS 在 MBC 与 IDC 疾病亚型之间无差异（风险比=1.16, 95% CI 0.48‐2.81）。 结论。在 MBC 女性的本项同期人群研究中, HER2 状态（而非 HR 状态）与生存率改善有关。HER2 阳性 MBC 与 HER2 阳性 IDC 的生存率相似。这表明 HER2 阳性 MBC 对 HER2 导向治疗有反应, 这一发现可为其他 MBC 治疗方法提供见解。 对临床实践的启示：本项人群研究按受体状态报告了化生性乳腺癌女性的近期预后。化生性乳腺癌的生存率不受激素受体状态的影响。据作者所知, 这是第一份指出人类表皮生长受体 2 (HER2) 阳性化生性乳腺癌女性的生存率高于 HER2 阴性化生性乳腺癌女性, 而与 HER2 阳性浸润性导管癌女性生存率相似的报告。这些信息可用于为诊断出化生性乳腺癌的患者提供建议。对 HER2 阳性化生性乳腺癌的进一步了解可更为广泛地为化生性乳腺癌的治疗方法开发提供见解
    [Abstract] [Full Text] [Related] [New Search]