Evidence map›Paper›PMID 40730725›Full record

ArticleAnnals of surgical oncology2025

Neoadjuvant Chemotherapy is Not Associated with Improved Overall Survival in Metaplastic Breast Cancer Regardless of Tumor Subtype.

Ellery H Reason, Samantha M Thomas, Tori Chanenchuk, Astrid M Botty van den Bruele, Maggie L DiNome, E Shelley Hwang, Kendra Modell Parrish, Ton Wang, Jennifer K Plichta, Alexandra Thomas and 2 more

Abstract read
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Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ellery H ReasonDuke University School of Medicine, Durham, NC, USA.
Samantha M ThomasDuke Cancer Institute, Duke University, Durham, NC, USA.
Tori ChanenchukDuke University School of Medicine, Durham, NC, USA.
Astrid M Botty van den BrueleDuke Cancer Institute, Duke University, Durham, NC, USA.
Maggie L DiNomeDuke Cancer Institute, Duke University, Durham, NC, USA.
E Shelley HwangDuke Cancer Institute, Duke University, Durham, NC, USA.
Kendra Modell ParrishDuke Cancer Institute, Duke University, Durham, NC, USA.
Ton WangDuke Cancer Institute, Duke University, Durham, NC, USA.
Jennifer K PlichtaDuke Cancer Institute, Duke University, Durham, NC, USA.
Alexandra ThomasDuke Cancer Institute, Duke University, Durham, NC, USA.
Akiko ChibaDuke Cancer Institute, Duke University, Durham, NC, USA.
Laura H RosenbergerDuke Cancer Institute, Duke University, Durham, NC, USA. Laura.Rosenberger@duke.edu.ORCID http://orcid.org/0000-0002-6829-6747

Funding

Dr. Jennifer Plichta is supported by the the NIH through grant K12AR084231 (PI: Amundsen) NIH grant K12AR084231Duke Cancer Institute for statistical supportDuke Cancer Institute NIH grant P30CA014236
6 · The paper itself

Abstract

introductionMetaplastic breast cancer (MpBC) is a rare breast cancer subtype historically less responsive to neoadjuvant chemotherapy (NAC), regardless of receptor status. Given increasing NAC administration in recent years, we analyzed contemporary treatment patterns and outcomes of patients with MpBC.

methodsPatients with MpBC were selected (2012-2020) from the National Cancer Database (NCDB). Patient characteristics were compared by receptor subtype. Unadjusted overall survival (OS) was estimated with the Kaplan-Meier method; log-rank tests were used to compare groups. Cox proportional hazard models were used to estimate the association of demographic and clinicopathologic variables with OS after adjustment.

resultsAmong 4,601 patients (median age, 64 years) with MpBC, 72.7% were triple negative (n = 3,344), 21.6% HR+/HER2- (n = 995), and 5.7% HER2+ (n = 262). More HER2+ patients received NAC (34.4%) than TN (20.6%) or HR+/HER- (16%, p < 0.001), but overall use of NAC remained low (20.4%). Unadjusted OS did not differ by receptor subtype or stage. Of those who received NAC, HER2+ patients had double the pCR rate (20%) compared with triple negative (9.1%) and HR+/HER2- (10.1%, p = 0.006). Adjuvant chemotherapy was associated with improved unadjusted OS at all timepoints, whereas NAC showed no survival benefit at 1 year and 3 years, a trend consistent across receptor subtypes. After adjustment, adjuvant chemotherapy remained associated with improved OS (HR 0.69, 95% CI 0.59-0.8).

conclusionsNeoadjuvant chemotherapy administration and pCR rates remain low for MpBC, and NAC is not associated with OS, supporting the treatment approach of upfront surgery and adjuvant chemotherapy. Further investigation is needed into novel systemic therapies to determine pCR rates and impact on OS.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsNeoadjuvant TherapyAdultAgedChemotherapy, AdjuvantErb-b2 Receptor Tyrosine KinasesFemaleFollow-Up StudiesHumansMetaplasiaMiddle AgedPrognosisReceptors, EstrogenReceptors, ProgesteroneSurvival RateERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenReceptors, ProgesteroneMetaplastic breast cancerNeoadjuvant chemotherapyOverall survival

Identifiers

PMID40730725

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.