Survival Outcomes in Metaplastic Versus Triple-Negative Invasive Breast Carcinoma: A Propensity Score-Matched Study.
4 affiliations
- 1Medical Oncology, Aydin Ataturk State Hospital, Aydin 09020, Türkiye.
- 2Medical Oncology, Ali Osman Sonmez Oncology Hospital, Bursa 16040, Türkiye.
- 3Medical Oncology, Bursa City Hospital, Bursa 16110, Türkiye.
- 4Radiation Oncology, Balikesir Ataturk City Hospital, Balikesir 10100, Türkiye.
Abstract
Background and Objectives: Metaplastic breast carcinoma (MBC) is a rare, predominantly triple-negative breast cancer subtype with aggressive clinical behaviour. This study compared the clinicopathological characteristics and survival outcomes of MBC with triple-negative invasive breast carcinoma (TN-IBC) and assessed the prognostic value of the neutrophil-to-lymphocyte ratio (NLR). Materials and Methods: Patients with stage I-III MBC or TN-IBC diagnosed between January 2003 and January 2024 were retrospectively reviewed. Among 35 patients with MBC and 103 with TN-IBC, 1:1 propensity score matching by age and TNM stage generated two groups of 35 patients. Disease-free survival (DFS) and overall survival (OS) were evaluated using Kaplan-Meier estimates and Cox proportional hazards models with robust sandwich variance clustered by matched pair. Results: All 70 matched patients had triple-negative disease. During a median follow-up of 7.7 years, recurrence occurred in 22.9% of patients with MBC and 17.1% of those with TN-IBC, while mortality rates were 25.7% and 8.6%, respectively. Five-year DFS rates were 73.9% and 85.2%, respectively; however, MBC was not significantly associated with DFS (HR = 1.70, 95% CI 0.67-4.30; p = 0.262). Five-year OS rates were 79.8% and 94.3%, respectively. Metaplastic histology was associated with a higher mortality hazard (HR = 3.53, 95% CI 1.01-12.41; p = 0.049). Median NLR was higher in MBC than in TN-IBC (2.31 vs. 1.85; p = 0.019). High NLR was associated with poorer OS in the overall matched cohort (HR = 3.36, 95% CI 1.07-10.57; p = 0.038), although NLR was not significantly associated with survival when analysed as a continuous variable or within the MBC subgroup. Conclusions: MBC was associated with inferior OS compared with TN-IBC after propensity score matching and pair-adjusted survival analysis, while DFS did not differ significantly. Elevated NLR was associated with poorer OS in the overall matched cohort but was not validated as an MBC-specific prognostic biomarker.
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BibTeX
@article{caner2026survival,
title = {{Survival Outcomes in Metaplastic Versus Triple-Negative Invasive Breast Carcinoma: A Propensity Score-Matched Study.}},
author = {Burcu Caner and Hulya Ertas and Sibel Oyucu Orhan and Seher Bahar},
journal = {Medicina (Kaunas, Lithuania)},
year = {2026},
month = oct,
doi = {10.3390/medicina62101944},
url = {https://europepmc.org/article/MED/42942475},
note = {CC BY},
}
RIS
TY - JOUR
TI - Survival Outcomes in Metaplastic Versus Triple-Negative Invasive Breast Carcinoma: A Propensity Score-Matched Study.
AU - Burcu Caner
AU - Hulya Ertas
AU - Sibel Oyucu Orhan
AU - Seher Bahar
PY - 2026
DA - 2026/10/08
JO - Medicina (Kaunas, Lithuania)
DO - 10.3390/medicina62101944
UR - https://europepmc.org/article/MED/42942475
AB - Background and Objectives: Metaplastic breast carcinoma (MBC) is a rare, predominantly triple-negative breast cancer subtype with aggressive clinical behaviour. This study compared the clinicopathological characteristics and survival outcomes of MBC with triple-negative invasive breast carcinoma (TN-IBC) and assessed the prognostic value of the neutrophil-to-lymphocyte ratio (NLR). Materials and Methods: Patients with stage I-III MBC or TN-IBC diagnosed between January 2003 and January 2024 were retrospectively reviewed. Among 35 patients with MBC and 103 with TN-IBC, 1:1 propensity score matching by age and TNM stage generated two groups of 35 patients. Disease-free survival (DFS) and overall survival (OS) were evaluated using Kaplan-Meier estimates and Cox proportional hazards models with robust sandwich variance clustered by matched pair. Results: All 70 matched patients had triple-negative disease. During a median follow-up of 7.7 years, recurrence occurred in 22.9% of patients with MBC and 17.1% of those with TN-IBC, while mortality rates were 25.7% and 8.6%, respectively. Five-year DFS rates were 73.9% and 85.2%, respectively; however, MBC was not significantly associated with DFS (HR = 1.70, 95% CI 0.67-4.30; p = 0.262). Five-year OS rates were 79.8% and 94.3%, respectively. Metaplastic histology was associated with a higher mortality hazard (HR = 3.53, 95% CI 1.01-12.41; p = 0.049). Median NLR was higher in MBC than in TN-IBC (2.31 vs. 1.85; p = 0.019). High NLR was associated with poorer OS in the overall matched cohort (HR = 3.36, 95% CI 1.07-10.57; p = 0.038), although NLR was not significantly associated with survival when analysed as a continuous variable or within the MBC subgroup. Conclusions: MBC was associated with inferior OS compared with TN-IBC after propensity score matching and pair-adjusted survival analysis, while DFS did not differ significantly. Elevated NLR was associated with poorer OS in the overall matched cohort but was not validated as an MBC-specific prognostic biomarker.
SN - 1010-660X
SN - 1648-9144
ER -