Is Chemotherapy Before Surgery Effective for Metaplastic Breast Cancer?

Metaplastic breast cancer is a rare but particularly aggressive form of breast tumor, accounting for less than 1% of all cases. Unlike more common breast cancers, this type typically responds poorly to conventional treatments, including traditional chemotherapy.

A recent study by researchers at the renowned Duke Cancer Institute (USA) analyzed data from 4,601 women diagnosed with this cancer between 2012 and 2020. The goal was clear: to determine whether chemotherapy before surgery (neoadjuvant chemotherapy) truly benefits patients with this diagnosis.

Key Study Findings

Low Usage Rate of Pre-Surgery Chemotherapy

• Only 1 in 5 patients (20%) received this treatment before surgery.

Disappointing Results with Pre-Surgery Chemotherapy

• Most patients did not achieve complete tumor elimination with this approach.
• No survival benefit was observed compared to those who didn’t receive it.

Better Outcomes with Surgery First

• Patients who underwent surgery first followed by chemotherapy showed improved survival.
• This was consistent across all subtypes (triple-negative, HER2+, and hormone receptor-positive).

What This Means in Practice

If you or a loved one face this diagnosis, these results suggest that:

✔ Surgery as a first step may be the most appropriate strategy in most cases.
✔ Chemotherapy after surgery appears to offer better outcomes.
✔ Your medical team will assess whether exceptions apply based on your specific characteristics.

The Future of Treatment

Researchers emphasize the urgent need to develop more effective therapies for this cancer, such as:

• Immunotherapies
• Personalized treatments based on molecular biology

Reference:
*Reason EH, et al. Neoadjuvant Chemotherapy is Not Associated with Improved Overall Survival in Metaplastic Breast Cancer Regardless of Tumor Subtype. Ann Surg Oncol. 2025. doi:10.1245/s10434-025-17938-x*