Follow up care for metaplastic carcinoma of the breast

MpBC Global Alliance, Inc. Recommendations

Metaplastic Breast Cancer is a uniquely complicated, rare breast cancer that to this date is not well understood.  Because of higher than normal incidence of metastatic disease in metaplastic breast cancer, follow up monitoring and scanning, either during neoadjuvant therapy or during and after initial treatment, can be critical.  Plans for monitoring and scanning should be discussed with a patient and their treating physician early in their treatment plan.  Based on surveys of our members, early detection of metastases has resulted in early adoption of additional therapies and has led to long-term survival and NED.

Referencing the ACS/ASCO April 2015 Breast Cancer Survivorship Care Guidelines, diagnosed patients may focus on the Guideline Disclaimer Section.  This publication specifically states:

  • “The Information herein should not be relied on as being complete or accurate, nor should it be considered as inclusive of all proper treatments of methods of care or as a statement of the standard of care.  With the rapid development of scientific knowledge, new evidence may emerge between the time information is developed and when it is published or read.”

The following is also stated:

  • “This information does not mandate any particular course of medical care.   Furthermore, the information is not intended to substitute for the independent professional judgment of the treating provider, as the information does not account for individual variation among patients.”

The Metaplastic Breast Cancer Global Alliance polled 30 Stage 4 diagnosed members in October 2018.   26 of the 30 reported metastatic disease within 18 months following initial treatments.

Conclusion: Based on the published guidelines and our members’ experiences, patients with metaplastic breast cancer should work with their physicians to establish an aggressive scanning protocol during and after treatment.  Physicians should evaluate these patients’ need for careful watching, especially during the first 2 years after treatment, and work with insurance providers to meet these patients’ needs.  Proactive scanning for re occurrence or advanced disease will help save lives and improve care.