International Consensus on the Clinical Management of Inflammatory Breast Cancer from the Morgan Welch Inflammatory Breast Cancer Research Program 10th Anniversary Conference

Abstract

National and international experts in inflammatory breast cancer (IBC) from high-volume centers treating IBC recently convened at the 10th Anniversary Conference of the Morgan Welch Inflammatory Breast Cancer Research Program at The University of Texas MD Anderson Cancer Center in Houston Texas. A consensus on the clinical management of patients with IBC was discussed, summarized, and subsequently reviewed. All participants at the conference (patients, advocates, researchers, trainees, and clinicians) were queried using the MDRing electronic survey on key management issues. A summary of the expert consensus and participant voting is presented. Bilateral breast and nodal evaluation, breast magnetic resonance imaging, positron emission tomography/computed tomography, and medical photographs were endorsed as optimal. Neoadjuvant systemic therapy, modified radical mastectomy and level I and II ipsilateral axillary node dissection, post-mastectomy radiotherapy, adjuvant targeted therapy and hormonal therapy as indicated, and delayed reconstruction were agreed-upon fundamental premises of standard non-protocol-based treatment for IBC. Consideration for local-regional therapy in de novo stage IV IBC was endorsed to provide local control whenever feasible. Variation across centers and special circumstances were discussed.

Literature-Wide Association Studies (LWAS) for a Rare Disease: Drug Repurposing for Inflammatory Breast Cancer

“…It is known that Carboplatin and Paclitaxel are the chemotherapies most often used for primary peritoneal carcinoma [ 46 ]. Indeed, Paclitaxel (Taxol), which is a taxane, is part of the standard neoadjuvant chemotherapy regime for IBC, although the use of Carboplatin as a standard chemotherapy for IBC still lacks consensus [ 24 ]. Furthermore, Doxorubicin, another one of the 24 drugs identified, is an anthracycline and was also endorsed as a standard treatment for IBC [ 24 ].…”

“…Indeed, Paclitaxel (Taxol), which is a taxane, is part of the standard neoadjuvant chemotherapy regime for IBC, although the use of Carboplatin as a standard chemotherapy for IBC still lacks consensus [ 24 ]. Furthermore, Doxorubicin, another one of the 24 drugs identified, is an anthracycline and was also endorsed as a standard treatment for IBC [ 24 ]. These facts appeared to support the discovery from our study.…”

“…Outcomes for IBC patients are worse in comparison to non-IBC breast cancer patients [ 23 ]. Standard treatment for IBC includes neoadjuvant chemotherapy, followed by mastectomy and then radiation therapy and is summarized in [ 24 ]. Depending on subtype, treatment may include HER2 targeted therapy or hormone therapy.…”

Targeting Signaling Pathways in Inflammatory Breast Cancer

“…The standard treatment for IBC is trimodality therapy, which consists of chemotherapy, surgery, and radiation. Although this therapeutic approach has significantly improved patient survival, the median survival of IBC patients remains poor [10]. We are in need of novel targeted therapies derived via understanding the molecular mechanism of IBC and identifying novel targets to improve patients' outcomes.…”

Patterns of breast reconstruction in patients diagnosed with inflammatory breast cancer: The Dana‐Farber Cancer Institute's Inflammatory Breast Cancer Program experience

“…Inflammatory breast cancer (IBC) is the most aggressive type of locally advanced breast carcinoma . There is a well‐defined treatment algorithm for the management of nonmetastatic IBC, known as “trimodality therapy” which consists of preoperative chemotherapy followed by modified radical mastectomy (MRM) followed by chest wall and regional nodal radiation therapy (RT) . Immediate breast reconstruction at the time of MRM is strongly discouraged for IBC patients because of the presence of dermal lymphatic invasion at presentation, whether or not it is documented by skin biopsy, and lack of safety data in this patient population for skin‐sparing mastectomies, required for a successful immediate reconstruction.…”