Metaplastic breast cancer

To radiate or not to radiate?

Warren H. Tseng, Steve R. Martinez

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Background: The role of radiation therapy (RT) is unclear for metaplastic breast cancer (MBC). We hypothesized that RT would improve overall survival (OS) and disease-specific survival (DSS). Materials and Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database to identify MBC patients diagnosed from1988 to 2006. Univariate analyses of patient, tumor, and treatment-specific factors on OS and DSS were performed using the Kaplan-Meier method and differences among survival curves assessed via log rank. Variables assessed included patient age, race/ethnicity, histologic subtype, tumor grade, T stage, N stage, M stage, hormone receptor status, surgery type, and use of RT. Cox proportional hazards models used all univariate covariates. Risks of mortality were reported as hazard ratios (HR) with 95% confidence intervals (95% CI); significance was set at P ≤ 0.05. Results: Among 1501 patients, RT was given to 580 (38.6%). Ten-year OS and DSS were 53.2, and 68.3%, respectively. In the overall analysis, RT provided an OS (HR 0.64; 95% CI, 0.51-0.82; P < 0.001) and DSS (HR 0.74; CI, 0.56-0.96; P < 0.03) benefit. When patients were stratified according to type of surgery, RT provided an OS but not a DSS benefit to lumpectomy (HR 0.51; CI, 0.32-0.79, P < 0.01) and mastectomy patients (HR 0.67; CI, 0.49-0.90; P < 0.01). Conclusions: Our findings support the use of RT for patients with MBC following lumpectomy or mastectomy. These retrospective findings should be confirmed in a prospective clinical trial.

Original languageEnglish (US)
Pages (from-to)94-103
Number of pages10
JournalAnnals of Surgical Oncology
Volume18
Issue number1
DOIs
StatePublished - Jan 2011

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Breast Neoplasms
Survival
Radiotherapy
Segmental Mastectomy
Mastectomy
Confidence Intervals
Proportional Hazards Models
Neoplasms
Epidemiology
Clinical Trials
Databases
Hormones
Mortality

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Metaplastic breast cancer : To radiate or not to radiate? / Tseng, Warren H.; Martinez, Steve R.

In: Annals of Surgical Oncology, Vol. 18, No. 1, 01.2011, p. 94-103.

Research output: Contribution to journalArticle

Tseng, Warren H. ; Martinez, Steve R. / Metaplastic breast cancer : To radiate or not to radiate?. In: Annals of Surgical Oncology. 2011 ; Vol. 18, No. 1. pp. 94-103.
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abstract = "Background: The role of radiation therapy (RT) is unclear for metaplastic breast cancer (MBC). We hypothesized that RT would improve overall survival (OS) and disease-specific survival (DSS). Materials and Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database to identify MBC patients diagnosed from1988 to 2006. Univariate analyses of patient, tumor, and treatment-specific factors on OS and DSS were performed using the Kaplan-Meier method and differences among survival curves assessed via log rank. Variables assessed included patient age, race/ethnicity, histologic subtype, tumor grade, T stage, N stage, M stage, hormone receptor status, surgery type, and use of RT. Cox proportional hazards models used all univariate covariates. Risks of mortality were reported as hazard ratios (HR) with 95{\%} confidence intervals (95{\%} CI); significance was set at P ≤ 0.05. Results: Among 1501 patients, RT was given to 580 (38.6{\%}). Ten-year OS and DSS were 53.2, and 68.3{\%}, respectively. In the overall analysis, RT provided an OS (HR 0.64; 95{\%} CI, 0.51-0.82; P < 0.001) and DSS (HR 0.74; CI, 0.56-0.96; P < 0.03) benefit. When patients were stratified according to type of surgery, RT provided an OS but not a DSS benefit to lumpectomy (HR 0.51; CI, 0.32-0.79, P < 0.01) and mastectomy patients (HR 0.67; CI, 0.49-0.90; P < 0.01). Conclusions: Our findings support the use of RT for patients with MBC following lumpectomy or mastectomy. These retrospective findings should be confirmed in a prospective clinical trial.",
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