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Clinicopathological Characteristics and Outcomes of Metaplastic Breast Cancer: Experience from a Tertiary Cancer Center in India
Vijaya L. V. Venkata,Donna C. P. Tharappel, Ganesha D. Vashishta, Rakesh S. Ramesh, Nirmala Srikantia, Akshai C. Kashiappa Introduction Metaplastic breast carcinoma (MBC) is a rare heterogeneous subtype of
breast cancer, with limited data. Currently, it is treated according to the invasive breast
cancer consensus guidelines, but it has a more distinct, aggressive biology and needs a
more specific management.
Objectives Our study aimed to evaluate the clinicopathological features, treatment
response, and survival outcomes of our MBC patients treated with standard treatment
modalities.
Materials and Methods We retrospectively analyzed clinicopathological character-
istics, treatment, and survival outcomes of 20 patients diagnosed with MBC between
2012 and 2025.
Results Twenty MBC patients were analyzed. The median age of presentation was
59.5 years. Fifty percent of patients had a clinical T3 tumor. Twenty percent had axillary
lymph node involvement. Preoperative core biopsy was MBC in 40%. Most patients
underwent mastectomy, and five patients underwent breast conservation surgery.
Seventy-five percent had triple-negative receptor status. Of the 35% patients who
received neoadjuvant chemotherapy (NACT), only one patient had a complete
response. Adjuvant radiation was administered to 65%. Twenty percent received
hormone therapy, and 5% received HER2-targeted therapy. At a median follow-up of
13.5 months (range: 3–72 months), 12 patients (60%) were alive with no evidence of
disease, and eight patients (40%) died. Tumor recurrence was seen in five patients
(25%). Overall survival (OS) at 1, 3, and 5 years was 84.4, 65.1, and 48.8%. Median OS
was 55.2 21.8 months. Recurrence-free survival was 64.7 15.8 months. Statistically
significant variable worsening the OS on univariate analysis was NACT (HR: 6.13, 95% CI: 1.09–34.46, p ¼ 0.040). However, none of the variables were statistically significant
by multivariate analysis.
Conclusion MBC is a rare and pathologically challenging diagnosis at core biopsy.
Despite the large size at presentation, initial surgery should be preferred whenever
feasible. Though lymph node metastasis is rare, when present, it has a worse prognosis.
