Evidence map›Paper›PMID 40928573›Full record

ArticleAnnals of surgical oncology2025

Neoadjuvant Versus Adjuvant Therapy for Metaplastic Breast Cancer: Insights from the National Cancer Database-Is There a Winning Strategy?

Fatemeh Shojaeian, Mahtab Vasigh, Haydee Del Calvo, Lourdes G Chaves, Miranda R Jones, Cesar Santa-Maria, Gayatri Nimmagadda, Olutayo Sogunro

Abstract readComparative Study
PubMed Publisher
In one paragraph

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

8 authors.

Fatemeh ShojaeianDepartment of Surgery,Division of Breast Surgical Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Mahtab VasighDepartment of Surgery,Division of Breast Surgical Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Haydee Del CalvoDepartment of Surgery,Division of Breast Surgical Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Lourdes G ChavesDepartment of Surgery,Division of Breast Surgical Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Miranda R JonesDepartment of Surgery,Division of Breast Surgical Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Cesar Santa-MariaJohns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA.
Gayatri NimmagaddaChesapeake Oncology-Hematology, Glen Bernie, MD, USA.
Olutayo SogunroDepartment of Surgery,Division of Breast Surgical Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. osogunr2@jhu.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study analyzed a large national cohort to compare treatment strategies and survival outcomes in metaplastic breast cancer (MtBC), a rare and aggressive subtype with poor treatment response. PATIENTS AND

methodsAdult female patients with MtBC diagnosed between 2006 and 2021 were identified from the National Cancer Database and grouped by chemotherapy sequence (neoadjuvant vs. adjuvant) to evaluate clinical characteristics and survival outcomes.

resultsAmong 9526 patients, 30.1% received neoadjuvant and 69.9% adjuvant chemotherapy. The cohort was predominantly white (76.7%) and non-Hispanic (90.8%), with a median age of 60 years; most had a comorbidity score of 0 (81%). Neoadjuvant therapy use increased from 14.3 to 43.9% and was more common among younger patients with advanced clinical stages. The immunotherapy administration grew from 0 to 23.95%. Over a mean follow-up of 69 months, 5-year overall survival was higher in the adjuvant group (80.7% vs. 66.7%). In multivariable analysis, adjuvant therapy was associated with improved overall survival [hazard ratio (HR) 0.65; 95% CI 0.54-0.72; p < 0.001]. Mastectomy, radiation, and higher income level were also linked to improved outcomes, while older age, nodal involvement, comorbidities, and lymphovascular invasion were associated with higher mortality.

conclusionsAdjuvant chemotherapy and aggressive local treatments were associated with improved survival, supporting a tailored approach that includes upfront surgery followed by adjuvant therapy as a potentially optimal strategy for operable cases. Meanwhile, the increasing use of neoadjuvant chemotherapy has coincided with rising survival rates, and the integration of immunotherapy into neoadjuvant regimens is also promising, highlighting the need for future studies.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsNeoadjuvant TherapyAdultAgedChemotherapy, AdjuvantDatabases, FactualFemaleFollow-Up StudiesHumansMastectomyMetaplasiaMiddle AgedPrognosisSurvival RateAdjuvant chemotherapyImmunotherapyMetaplastic breast cancerNational Cancer DatabaseNeoadjuvant chemotherapySurvival outcomeTreatment strategies

Identifiers

PMID40928573

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