Differences in survival among women with stage III inflammatory and noninflammatory locally advanced breast cancer appear early

Abstract

BACKGROUND: Significant improvements in the survival of women with breast cancer have been observed and are attributed to a multidisciplinary approach and the introduction of polychemotherapy and endocrine regimens. The objective of this population-based study was to determine whether women with inflammatory breast cancer (IBC) who received treatment in a modern era had a poorer survival compared those with non-IBC locally advanced breast cancer (LABC). METHODS: The Surveillance, Epidemiology, and End Results program registry was searched to identify women with stage IIIB/C breast cancer diagnosed between 2004 and 2007 who had undergone surgery and radiotherapy. Patients were categorized as either having IBC or non-IBC LABC according the sixth edition of the American Joint Committee on Cancer (AJCC) criteria. Breast cancer-specific survival (BCS) was estimated using the Kaplan-Meier product limit method and compared across groups using the log-rank statistic. Cox models were then fitted to compare the association between breast cancer type and BCS after adjusting for patient and tumor characteristics. RESULTS: A total of 828 (19.2%) women and 3476 (80.8%) women had stage IIIB/C IBC and non-IBC LABC, respectively. The median follow-up was 19 months. The 2-year BCS rate was 90% (95% confidence interval [95% CI], 88%-91%) for the entire cohort and 84% (95%CI, 80%-87%) and 91% (95%CI, 90%-91%) among women with IBC and non-IBC LABC, respectively. In the multivariable model, patients with IBC were found to have a 43% increased risk of death from breast cancer compared with patients with non-IBC LABC (hazard ratio, 1.43; 95%CI, 1.10-1.86 [P ¼ .008]). CONCLUSIONS: In the era of multidisciplinary management and anthracycline-based and taxane-based polychemotherapy regimens, women with IBC continue to have worse survival outcomes compared with those with non-IBC LABC.

Are Breast Cancer Subtypes Prognostic for Nodal Involvement and Associated with Clinicopathologic Features at Presentation in Early-Stage Breast Cancer?

“…The existing literature suggests a significant association between BCS and outcomes (18, 31, 32) with the worst DFS, DMFS and OS for TN subtypes (31, 32). Our findings are consistent with the existing literature in that we demonstrated a similar association between these outcomes and BCS, with TN having worse overall outcomes.…”

Lessons Learned from an Unusual Case of Inflammatory Breast Cancer

“…12 Other studies have reported 2-, 10-, and 20-year overall survival rates of 82%, 32%-38%, and 19%, respectively using various regimens. [13][14][15][16] Although radiotherapy retreatment is common across many types of cancer, median time between retreatment episodes has been observed to be longest in breast cancer (12.5 months). 17 As our patient was treated several years prior with radiotherapy for DCIS, the need for repeat radiotherapy adds complexity to her care.…”

The classification of invasive carcinoma of the breast

“…Inflammatory carcinomas are usually triple negative or HER2 positive. The prognosis has improved due to the use of neoadjuvant chemotherapy [76] but overall outcome remains worse than for patients with non-inflammatory locally advanced breast carcinoma [77]. Inflammatory carcinoma of the breast may be associated with a specific alteration in the activation of the anaplastic lymphoma kinase (ALK) pathway due to amplification of the ALK gene at 2p23 locus.…”