The Impact of Subtype Distribution in Inflammatory Breast Cancer Outcome

Çakar, Burcu; Surmeli, Zeki Gokhan; Öner, Pınar Gürsoy; Yelim, Elif Sıla; Karabulut, Bülent; Uslu, Rüçhan

doi:10.5152/ejbh.2018.4170

Cited by 13 publications

(10 citation statements)

References 21 publications

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“…Additionally, patients with unknown biologic subtype were excluded in the SEER analysis. Nonetheless, this study reported poor survival for patients with TN-IBC, which is consistent with our report and other studies in the literature [24,53,54,55].…”

Section: Discussionsupporting

confidence: 93%

“…This is similar to a recent study of 7304 women with non-metastatic IBC, wherein radiotherapy was associated with improved 5-year survival (adjusted HR = 0.64, 95% CI 0.61–0.69) [69]. Nonetheless, a multidisciplinary multimodal approach consisting of NACT followed by surgery and post-mastectomy radiation has been underutilized in previous reports of IBC [55,70].…”

Section: Discussionsupporting

confidence: 85%

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Pathologic Complete Response (pCR) and Survival of Women with Inflammatory Breast Cancer (IBC): An Analysis Based on Biologic Subtypes and Demographic Characteristics

Biswas

Jindal

Fitzgerald

et al. 2019

IJERPH

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In this US-based study of the National Cancer Database (NCDB), we examined 8550 patients diagnosed with non-metastatic, invasive inflammatory breast cancer (IBC) who received surgery from 2004–2013. Patients were grouped into four biologic subtypes (HR+/HER2−, HR+/HER2+, HR−/HER2+, HR−/HER2−). On average, women were 56 years of age at diagnosis and were followed for a median of 3.7 years. The majority were white (80%), had private health insurance (50%), and presented with poorly differentiated tumors (57%). Approximately 46% of the cancers were >5 cm. Most patients underwent mastectomy (94%) and received radiotherapy (71%). Differences by biologic subtypes were observed for grade, lymph node invasion, race, and tumor size (p < 0.0001). Patients experiencing pathologic complete response (pCR, 12%) vs. non-pCR had superior 5-year overall survival (OS) (77% vs. 54%) (p < 0.0001). Survival was poor for triple-negative (TN) tumors (37%) vs. other biologic subtypes (60%) (p < 0.0001). On multivariable analysis, TN-IBC, positive margins, and not receiving either chemotherapy, hormonal therapy or radiotherapy were independently associated with poor 5-year survival (p < 0.0001). In this analysis of IBC, categorized by biologic subtypes, we observed significant differential tumor, patient and treatment characteristics, and OS.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 85%

Pathologic Complete Response (pCR) and Survival of Women with Inflammatory Breast Cancer (IBC): An Analysis Based on Biologic Subtypes and Demographic Characteristics

Biswas

Jindal

Fitzgerald

et al. 2019

IJERPH

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“…In stage IV disease, the median OS is 2.27 years in IBC patients versus 3.40 years in non-IBC patients [7,8]. Although IBC, like non-IBC breast cancers, is a heterogeneous disease and can occur as any of the four molecular subtypes, it is most commonly either human epidermal growth factor receptor 2 (HER2) overexpressive or triple negative (TN) [9,10]. TN breast cancer, which is defined by the absence of estrogen and progesterone receptors, and a lack of HER2 overexpression, has a poorer prognosis than other subtypes [11].…”

Section: Introductionmentioning

confidence: 99%

Genetic Variants Detected Using Cell-Free DNA from Blood and Tumor Samples in Patients with Inflammatory Breast Cancer

Winn

Hasse

Slifker

et al. 2020

IJMS

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We studied genomic alterations in 19 inflammatory breast cancer (IBC) patients with advanced disease using samples of tissue and paired blood serum or plasma (cell-free DNA, cfDNA) by targeted next generation sequencing (NGS). At diagnosis, the disease was triple negative (TN) in eleven patients (57.8%), ER+ Her2- IBC in six patients (31.6%), ER+ Her2+ IBC in one patient (5.3%), and ER- Her2+ IBC in one other patient (5.3%). Pathogenic or likely pathogenic variants were frequently detected in TP53 (47.3%), PMS2 (26.3%), MRE11 (26.3%), RB1 (10.5%), BRCA1 (10.5%), PTEN (10.5%) and AR (10.5%); other affected genes included PMS1, KMT2C, BRCA2, PALB2, MUTYH, MEN1, MSH2, CHEK2, NCOR1, PIK3CA, ESR1 and MAP2K4. In 15 of the 19 patients in which tissue and paired blood were collected at the same time point, 80% of the variants detected in tissue were also detected in the paired cfDNA. Higher concordance between tissue and cfDNA was found for variants with higher allele fraction in tissue (AFtissue ≥ 5%). Furthermore, 86% of the variants detected in cfDNA were also detected in paired tissue. Our study suggests that the genetic profile measured in blood cfDNA is complementary to that of tumor tissue in IBC patients.

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“…In our study, prognostic stage IIIC, which included (1) ER+/PR−/HER2−/grade 3, (2) ER−/PR+/HER2−/grade 3, and (3) triple-negative IBC, had significantly worse prognoses than other stages in both cohorts. Six previous studies investigating the relationship between subtypes and survival outcomes in IBC have reported that triple-negative IBC has the worst survival outcomes [ 9 , 10 , 11 , 12 , 13 , 14 ]. These studies supported our findings that IBC’s prognostic stage IIIC has a poor prognosis because the triple-negative type is the major component of prognostic stage IIIC.…”

Section: Discussionmentioning

confidence: 99%

Validation of Prognostic Stage and Anatomic Stage in the American Joint Committee on Cancer 8th Edition for Inflammatory Breast Cancer

Kida

Hess

Iwase

et al. 2020

Cancers

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The AJCC updated its breast cancer staging system to incorporate biological factors in the “prognostic stage”. We undertook this study to validate the prognostic and anatomic stages for inflammatory breast cancer (IBC). We established two cohorts of IBC diagnosed without distant metastasis: (1) patients treated at The University of Texas MD Anderson Cancer Center between 1991 and 2017 (MDA cohort) and (2) patients registered in the national Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015 (SEER cohort). For prognostic staging, estrogen receptor (ER)+/progesterone receptor (PR)+/ human epidermal growth factor receptor-2 (HER2)+/grade 1–2 was staged as IIIA; ER+/PR−/HER2−/grade 3, ER−/PR+/HER2−/grade 3, and triple-negative cancers as IIIC; and all others as IIIB. Endpoints were breast cancer-specific survival (BCSS), overall survival (OS), and disease-free survival (DFS). We studied 885 patients in the MDA cohort and 338 in the SEER cohort. In the MDA cohort, the prognostic stage showed significant predictive power for BCSS, OS, and DFS (all p < 0.0001), although the anatomic stage did not. In both cohorts, the Harrell concordance index (C index) was significantly higher in the prognostic stage than the anatomic stage for all endpoints. In conclusion, the prognostic stage provided more accurate prognostication for IBC than the anatomic stage. Our results show that the prognostic staging is applicable in IBC.

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The Impact of Subtype Distribution in Inflammatory Breast Cancer Outcome

Cited by 13 publications

References 21 publications

Pathologic Complete Response (pCR) and Survival of Women with Inflammatory Breast Cancer (IBC): An Analysis Based on Biologic Subtypes and Demographic Characteristics

Pathologic Complete Response (pCR) and Survival of Women with Inflammatory Breast Cancer (IBC): An Analysis Based on Biologic Subtypes and Demographic Characteristics

Genetic Variants Detected Using Cell-Free DNA from Blood and Tumor Samples in Patients with Inflammatory Breast Cancer

Validation of Prognostic Stage and Anatomic Stage in the American Joint Committee on Cancer 8th Edition for Inflammatory Breast Cancer

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