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Background: Studies reported the hormonal receptor (HR) status was not associated with survival in metaplastic breast cancer (MBC). In addition, MBC patients cannot benefit from chemotherapy (CT). The present study aimed to evaluate the efficacy of CT on MBC patients with high risk (T1-4N2-3M0 and T4N0-1M0) by propensity-score matching (PSM). Methods: A retrospective study was performed to analyze MBC from the SEER database. Breast cancer-specific survival (BCSS) rates were analyzed using the Kaplan–Meier curve and differences assessed by log-rank tests. Cox proportional hazard models were used to assess BCSS. PSM was used to make 1:1 case-control matching.Results: We identified 3116 patients. The median follow-up time was 44 months (range, 1–321 months). 23.0% of patients were HR-positive. About 62.5% of patients received CT, which seem not to relate to HR status. Recurrence risk had a significant difference between HR-negative and HR-positive groups. In the multivariable Cox proportional hazards regression model, HR status was not associated with a better BCSS. CT had no benefit for MBC. Multivariate analyses after PSM (n=1274) confirmed that both CT and HR status were not associated with prognosis. The Kaplan–Meier curve before PSM showed that HR-negative MBC with intermediate-risk benefited from CT. For HR-positive MBC, patients with intermediate and high risk benefited from CT. However, CT could only benefit for HR-positive MBC with high risk after PSM.Conclusion: PSM analysis showed that CT could only benefit for HR-positive MBC with high risk.