Treatment of Metaplastic Breast Cancer in the U.S.: Asian Patient Receives Latest Treatment Plan via Remote Video Consultation with Leading U.S. Experts
- medebound
- Jan 13
- 11 min read
Updated: Jan 16
Author: Medical Editor Jasmine
What is Metaplastic Breast Cancer, and how common is it?
Metaplastic breast cancer is a rare, highly aggressive form of breast cancer, accounting for less than 1% of all breast cancers. The incidence generally ranges from 0.2% to 1%. It is often detected as a rapidly enlarging mass in the breast. Although it appears similar to invasive ductal carcinoma on imaging tests, the tumor size of metaplastic breast cancer is often larger at diagnosis.
WHO Breast Tumor Classification classifies metaplastic breast cancer as mixed metaplastic carcinoma, low-grade adenosquamous carcinoma, fibromatosis-like carcinoma, squamous cell carcinoma, spindle cell carcinoma, and metaplastic carcinoma with stromal differentiation. Most metaplastic breast cancers are triple-negative breast cancers (i.e., do not express estrogen receptor, progesterone receptor, or HER2 protein), which limits the effectiveness of traditional endocrine and targeted therapies. Due to its unique biological behavior, metaplastic breast cancer generally has a poor prognosis and requires individualized treatment plans.
How is Metaplastic Breast Cancer treated?
Metaplastic breast cancer is characterized by its tendency to spread to areas outside the breast. Due to the lack of clear treatment guidelines, the approach is generally more aggressive.
Treatment strategies depend on the cancer's stage and may include chemotherapy (to shrink the tumor, though standard chemotherapy regimens may have limited efficacy and may be combined with immunotherapy), surgery (tumor removal, with bilateral mastectomy as an option), radiation therapy (to shrink the tumor, kill cancer cells, and relieve pain), and newer therapies (such as targeted therapy, immune modulators, and antibody-drug conjugates, which may serve as potential alternatives to standard chemotherapy).
Since metaplastic breast cancer accounts for less than 1% of all breast cancer diagnoses and clinical trials are limited, its treatment typically follows similar principles to other breast cancers of the same stage and characteristics. Additionally, to reduce the risk of development, it is recommended to undergo regular mammography screenings as advised by a doctor.
Can Metaplastic Breast Cancer be cured?
Metaplastic breast cancer is generally considered incurable. Due to its aggressive nature, rapid tendency to spread, and limited treatment options, it is often diagnosed at an advanced stage, meaning most patients can only manage the disease through treatment rather than achieve a complete cure.
Studies show that the prognosis of metaplastic breast cancer is worse than that of triple-negative invasive ductal carcinoma (TN-IDC), with 5-year overall survival rates of 54.5% and 73.3%, respectively. The 5-year overall survival rate for spindle cell-differentiated adenocarcinoma is the lowest, at 40%.
Advantages and Latest Advances in Treating Metaplastic Breast Cancer in the U.S.
Advantages of Treating Metaplastic Breast Cancer in the U.S.
The U.S. offers several advantages in the treatment of metaplastic breast cancer compared to other countries or regions, primarily in the following aspects:
1.Advanced Medical Technology and Innovative Therapies
The U.S. is at the forefront of precision medicine and personalized treatment for breast cancer. For metaplastic breast cancer, U.S. clinicians may employ more advanced surgical techniques, radiation methods, and innovative drug therapies such as targeted therapy and immunotherapy. These treatments may significantly improve patient survival rates and quality of life.
For example, targeted drugs or immunotherapies developed for specific gene mutations or abnormal signaling pathways may be utilized in the U.S., therapies that might still be in the research phase or less commonly used in other regions.
2.Rich Clinical Experience and Multidisciplinary Comprehensive Treatment
The U.S. is home to many specialized breast cancer treatment centers and medical teams with extensive clinical experience.
Given the complexity and rarity of metaplastic breast cancer, U.S. hospitals typically adopt a multidisciplinary approach, involving experts from surgery, oncology, radiation therapy, pathology, and imaging, who collaborate to formulate the most effective treatment plan, ensuring the best possible outcome for patients.
3.Strict Medical Quality Regulation and Assurance
The U.S. has a well-established medical quality regulatory system, with strict guidelines and oversight concerning hospital and physician qualifications, medical equipment certifications, and drug approvals.
This helps ensure that patients with metaplastic breast cancer receive high-quality medical services and safe drug treatments throughout their treatment journey.
4.Higher Survival Rates
According to statistics, the five-year survival rate for breast cancer patients in the U.S. is relatively high, likely due to advanced medical technology, extensive clinical experience, and a robust regulatory system.
Although metaplastic breast cancer generally has a poorer prognosis, the U.S. may offer a higher success rate and better patient outcomes in treating this rare subtype.
5.Continuous Research Investment and Innovation
The U.S. makes substantial investments in medical research, which helps drive the continuous innovation and development of breast cancer treatments.
For metaplastic breast cancer and other complex subtypes, U.S. scientists and doctors are likely to conduct more clinical studies and trials to explore more effective treatment methods.
Latest Advances in Treating Metaplastic Breast Cancer in the U.S.
As mentioned earlier, metaplastic breast cancer is typically triple-negative breast cancer (TNBC) and does not respond to hormone therapies used for ER+, PR+, or HER2+ cancers. Due to its often chemotherapy-resistant nature, there is currently no specific treatment standard. Thus, patients diagnosed with metaplastic breast cancer are generally treated with chemotherapy regimens used for triple-negative breast cancer.
Antibody-Drug Conjugates: Sacituzumab Govitecan (Trodelvy)
Sacituzumab Govitecan (Trodelvy) is a Trop-2 targeted antibody-drug conjugate used for metastatic triple-negative breast cancer (mTNBC). In the global Phase III ASCENT trial, Trodelvy significantly improved progression-free survival, overall survival, and objective response rates. The U.S. FDA has approved it for the treatment of adults with locally advanced or mTNBC who have received at least two prior therapies.
Antibody-Drug Conjugates: Trastuzumab Deruxtecan (T-DXd)
Results from the Phase 3 DESTINY-Breast06 clinical trial presented at the 2024 American Society of Clinical Oncology (ASCO) meeting showed that, compared to chemotherapy, trastuzumab deruxtecan significantly extended progression-free survival by approximately 5 months in patients with metastatic HR-positive, HER2-low, and HER2 ultra-low breast cancer. T-DXd is poised to redefine the treatment of metastatic breast cancer.
Pembrolizumab (KEYTRUDA)
In the U.S., KEYTRUDA can be used for high-risk early-stage triple-negative breast cancer (TNBC) patients in combination with chemotherapy as neoadjuvant therapy, and as a single agent for adjuvant therapy following surgery.
KEYTRUDA in combination with chemotherapy is also FDA-approved for the treatment of locally recurrent, unresectable, or metastatic TNBC patients whose tumors express PD-L1 (CPS ≥10).
Leading Hospitals and Experts in Treating Metaplastic Breast Cancer in the U.S.
MD Anderson Cancer Center
Location: Houston, Texas
Advantages: MD Anderson's breast cancer specialists are experts in diagnosing and staging rare cancers and developing new treatment methods. Their research findings are applied to about 60% of the cancer drugs approved by the FDA in 2023. In the 2024-2025 U.S. News & World Report "Best Hospitals" rankings, MD Anderson Cancer Center was recognized as the top cancer treatment hospital in the U.S. Additionally, MD Anderson provides personalized care and multidisciplinary treatment at five locations in the Houston area.
Mayo Clinic
Location: Rochester, Minnesota
Advantages: Renowned for its comprehensive healthcare, Mayo Clinic's oncology department is known for its outstanding medical team and innovative treatment methods. The clinic offers efficient diagnostic and therapeutic services for breast cancer patients, from genetic testing to comprehensive treatment, particularly excelling in treating high-risk or recurrent breast cancer patients.
Memorial Sloan Kettering Cancer Center (MSKCC)
Location: New York City
Advantages: One of the oldest and largest cancer centers in the world, MSKCC is ranked as the second-best cancer hospital in the U.S. MSKCC has a specialized program for rare breast cancers, focusing on providing the latest antibody-drug conjugates and clinical trials, offering patients cutting-edge treatment options. The hospital has over 120 laboratories dedicated to various types of cancer research, providing technical and expert support for researchers.
Top Expert: Dr. Nour, Director of the Rare Breast Cancer Program at MSKCC; Co-Director of the Triple-Negative Breast Cancer Clinical Research Program. She specializes in studying the immune microenvironment of breast cancer and is committed to optimizing personalized treatment plans, especially for triple-negative breast cancer and rare subtypes like metaplastic breast cancer. Her insights and treatment strategies in this area are highly regarded.
Costs of Treating Metaplastic Breast Cancer in the U.S.
Due to the rarity of metaplastic breast cancer, there is no specific data available on the treatment costs for this condition. However, U.S. researchers have published an analysis of insurance claims data for breast cancer patients. This study included 8,360 female breast cancer patients and categorized them based on disease stage (Stage 0, I/II, III, and IV). The study found that patients diagnosed at later cancer stages incurred higher treatment costs within the first six months (0-6 months, 0-12 months, 0-18 months, and 0-24 months) of diagnosis.
Specifically, within one year after diagnosis, insurance companies paid the following average costs for patients at Stage 0, I/II, III, and IV: $60,637, $82,121, $129,387, and $134,682, respectively.
Within 24 months of diagnosis, the average costs for each stage of the disease were $71,909, $97,066, $159,442, and $182,655, respectively. Thus, compared to early-stage breast cancer, the incremental costs of treating late-stage breast cancer are significantly higher.
However, the treatment costs for metaplastic breast cancer may be even higher. The exact figures will vary based on the patient's treatment plan, the region, and the medical institution.
Pain Points for International Patients with Metaplastic Breast Cancer
For families facing a serious diagnosis, accessing advanced therapies in the U.S. often feels out of reach.
Challenge 1: Difficulty in Choosing Treatment Options
Patients may lack understanding of various treatment options (such as medications or surgery), making it challenging to make informed decisions.
Challenge 2: High Medical Costs
Long-term treatment for breast cancer can lead to significant financial strain for patients, not including the expenses of long-distance travel, accommodation, and living costs. Moreover, 95% of international patients lack insurance coverage for these expenses.
Challenge 3: Language and Cultural Barriers
International patients may face challenges related to language communication and cultural differences when seeking medical care across countries, which can affect the effectiveness of treatment.
Challenge 4: The Need for Long-Term Stay in the U.S. or Frequent Travel Between Countries
Treatment for metaplastic breast cancer is a long-term process, and temporary relief does not equal long-term remission. For some patients, traveling to the U.S. may mean a prolonged stay, or the need for frequent back-and-forth travel between countries.
So, is there a way to help reduce the burden on patients?
Yes, indeed there is.
Case of an Asian Metaplastic Breast Cancer Patient Receiving Remote Video Consultation with U.S. Experts
A 56-year-old Asian female was diagnosed with invasive ductal carcinoma of the right breast in December 2022 and underwent a comprehensive treatment regimen including chemotherapy, surgery, and radiation therapy.
However, in April 2024, she was diagnosed with invasive ductal carcinoma of the left breast, which was also triple-negative breast cancer (TNBC).
After multiple attempts with chemotherapy, the tumor continued to grow. Ultimately, she underwent a left breast mastectomy in September 2024, and post-operative pathology confirmed the diagnosis of metaplastic breast cancer with lymph node metastasis.
After consulting multiple domestic medical institutions and gathering extensive information online, the patient and her family realized that the cancer was extremely rare and that the available treatment options in their region were very limited. Therefore, they decided to seek treatment in the United States.
In this situation, the patient and her family reached out to MEDEBOUND HEALTH — a cross-border medical service provider with 9 years of overseas medical experience and a patient satisfaction rate of 95%.
Through MEDEBOUND HEALTH's professional coordination and extensive medical network, we successfully connected the patient with Dr. Nour, the Director of the Rare Breast Cancer Program at Memorial Sloan Kettering Cancer Center (MSKCC).
In the video consultation, Dr. Nour thoroughly explained to the patient and their family the rarity of metaplastic breast cancer and why the patient needed to undergo multiple treatments. It was only after surgery and pathological diagnosis that the cancer was ultimately confirmed as metaplastic breast cancer. Additionally, the professor answered all of the patient’s questions regarding the treatment plan, subsequent recurrence monitoring, and family member screening plans.
The consultation lasted for over an hour, and after the session, Dr. Nour kindly responded to further questions from the patient's family online. Below is a summary of the consultation:
Pathological Diagnosis: Consistent with the domestic diagnosis, the patient was diagnosed with metaplastic breast cancer (spindle cell subtype).
Tumor Metastasis and Staging: No distant metastasis was observed on the PET scan. Close follow-up is recommended, and circulating tumor DNA testing should be considered to monitor for recurrence.
Treatment Plan: Given the patient’s lack of sensitivity to both chemotherapy and immunotherapy, Dr. Nour recommends attempting novel antibody-drug conjugates (e.g., sacituzumab govitecan, trastuzumab deruxtecan) in combination with immunotherapy.
Clinical Trials: It is recommended to participate in clinical trials related to the novel antibody-drug conjugates to test specific drug treatments, with the aim of achieving better treatment outcomes.
Adjunctive Therapies: The addition of psychological support and acupuncture is recommended to help alleviate the patient’s stress.
Genetic Mutations and Inherited Risk: The significance of the BRCA1 mutation is unclear, but it may change in the future. Family members may consider genetic testing (optional).
Strict Monitoring: Due to the chemotherapy resistance and high recurrence risk of metaplastic breast cancer, Dr. Nour recommends performing a PET scan every 3 months during the first year post-surgery, every 4 months in the second year, and every 6 months in the third year. From the second year after surgery, circulating tumor DNA testing may be added, alternating with PET scans, to detect recurrence earlier.
Special Reminders from the Expert:
For any suspicious lesions, biopsy is required to confirm whether it is truly metastatic disease.
Immunotherapy may lead to pseudoprogression, and close monitoring of tumor changes is needed.
If the ADC regimen (sacituzumab govitecan + pembrolizumab) is used, special caution should be taken for potential damage to organs like the pancreas, and appropriate symptomatic treatments should be prepared.
Follow-up After Treatment in the U.S.
The patient and family confirmed the final treatment plan with Dr. Nour, and with the professional assistance of MEDEBOUND HEALTH, they successfully arrived in the U.S. and were enrolled in a rare breast cancer clinical trial at Memorial Sloan Kettering Cancer Center (MSKCC). There, the patient received an innovative regimen combining a novel antibody-drug conjugate with immunotherapy.
Under strict monitoring and careful treatment, the patient's condition remained stable, the tumor was effectively controlled, and the quality of life significantly improved.
Patient Testimonial
The patient and her family expressed high recognition and gratitude for Dr. Nour’s consultation and in-person treatment. They believe that this remote consultation and the opportunity to receive treatment in the U.S. have provided new hope and direction for her treatment.
The family also highly praised Medebound HEALTH's professional services and proactively stated that they would recommend us to local renowned hospitals, helping more patients connect to U.S. medical services.
How Medebound HEALTH Supports You:
1. Initial Consultation: Connect with us to discover your needs. Our dedicated care team will concisely outline all treatment options, ensuring you understand each choice without feeling overwhelmed or stressed.
2. Doctor Consultation: We'll arrange a remote video consultation with an expert from a prestigious U.S. hospital. Language barriers are no issue, as we provide professional translation services to facilitate clear and comfortable communication between you and the doctor about your condition and recovery goals.
3. Tailored Treatment Plan: Following the doctor's consultation, we'll help you devise a personalized treatment plan. We'll clearly explain which treatments may be advantageous for you, the duration of treatment, associated costs, and expected outcomes.
4. Travel Facilitation: If traveling to the U.S. for treatment is necessary, we'll streamline the process for you. We'll handle visa applications, flight bookings, accommodations near the hospital, airport transfers, and all travel arrangements for your family.
5.Hospital Arrival Support: Upon arrival at the U.S. hospital, our team will be there to guide you through every step. We'll assist with doctor communication, explain treatment plans, support your family, and leverage our years of partnership with U.S. hospitals to secure the maximum discount for you, which can sometimes reach 15%-50%—far surpassing the discounts patients can typically negotiate on their own.
6. Ongoing Recovery Support: Even after returning home, our care continues. We'll support your rehabilitation efforts, monitor your recovery progress, arrange follow-up doctor consultations as needed, and be with you every step of the way until you achieve your recovery goals.
Medebound HEALTH: Connecting You to the World's Top Medical Resources
If you or your family members are seeking world-class treatment for complex conditions, Medebound HEALTH is your best choice. Through our partnerships with top-tier medical institutions in the United States, whether through remote video consultations or traveling to the US for treatment, we provide full support every step of the way.
Contact us:
Website: https://www.medeboundhealth.com/
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