![]() The American Joint Committee on Cancer Staging (AJCC) system is the most commonly used to assess a patient’s prognosis for breast cancer ( 3). The majority of MBC’s local and system-optimally regulated treatment approaches are deduced from IDC’s treatment practice and have not been rigorously confirmed in MBC patients. ![]() Due to the rarity of MBC, limitations of tailored understanding of the clinical characteristics and prognosis exist in previous reports. MBC has been considered more aggressive, with poor clinical outcomes and a large unmet demand for treatment, compared to invasive ductal breast carcinoma(IDC). Metaplastic breast cancer (MBC) is a group of rare and heterogeneous invasive carcinomas, characterized by cell differentiation of the tumor epithelium towards squamous and/or mesenchymal-like components such as spindle cells, chondrocytes, and osteoblasts, accounting for only 0.2-5% of all breast cancer ( 2). This nomogram is recommended for patients with MBC, both American and Chinese, which can help clinicians make more accurate individualized survival analyses.įemale breast cancer has overtaken others as the most commonly diagnosed malignancy, with an expected 2.3 million new cases in 2020, based on data from the International Agency for Research on Cancer ( 1). Nomogram’s great predictive capability capacity further was supported by the comparatively high C-index of the validation II sets (0.728 95%CI 0.588-0.869).Ĭonclusions: Metaplastic breast cancer is more aggressive, with a worse clinical prognosis than IDC. In the validation I cohort, the nomogram’s C-index (0.769 95% CI 0.710 -0.828) was indicated to be considerably higher than the standard AJCC model’s (0.700 95% CI 0.644 -0.756). Age at diagnosis, T, N, and M stage, as well as surgery and radiation treatment, were all significant independent prognostic factors for overall survival (OS). Results: MBC had a significantly higher T stage (T2 and above accounting for 75.1% vs 39.9%), fewer infiltrated lymph nodes (N0 accounted for 76.2% vs 67.7%), a lower proportion of ER (22.2% vs 81.2%), PR (13.6% vs 71.4%), and HER-2(6.7% vs 17.7%) positive, radiotherapy(51.6% vs 58.0%) but more chemotherapy(67.5% vs 44.7%), and a higher rate of mastectomy(53.2% vs 36.8%), which was discovered when comparing the clinical baseline data between MBC and IDC. The discriminative power, calibration, and clinical effectiveness of the nomogram were evaluated by the concordance index (C-index), the receiver operating characteristic (ROC) curve, and the decision curve analysis (DCA). The nomogram was constructed to predict individual survival outcomes for MBC patients. The independent prognostic factors were selected by univariate and multivariate Cox regression analyses. Meanwhile, the performance of this model was validated again by the validation II set, which consisted of MBC patients from the Union Hospital of Fujian Medical University between 20. ![]() MBC patients were randomly allocated to the training set and validation I set by a ratio of eight to two. The survival outcomes of patients between MBC and IDC were analyzed and compared with the Kaplan-Meier (KM) method. Methods: We searched the Surveillance, Epidemiology, and End Results (SEER) database for data about patients including metaplastic breast cancer and infiltrating ductal carcinoma (IDC) from 2010 to 2018. This study aims to develop and validate a nomogram to predict the overall survival (OS) of patients with MBC. ![]() 5Department of Breast Surgery, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, Chinaīackground: Metaplastic breast cancer (MBC) is a rare breast tumor and the prognostic factors for survival in patients still remain controversial. ![]()
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