Treatment adherence and outcome in women with inflammatory breast cancer

Abstract

BACKGROUND:The authors compared treatment adherence rates and outcome in Caucasian and African American patients with inflammatory breast cancer (IBC). METHODS: The records of 55 (25 Caucasian and 30 African American) IBC patients treated with curative intent from 1995 to 2009 were reviewed. All patients received neoadjuvant doxorubicin (Adriamycin) and/or taxane-based chemotherapy, and mastectomy with or without radiotherapy. The median follow-up period for Caucasian and African American patients was similar (39.5 months and 36.1 months, respectively). RESULTS: There was no difference between races in median age, tumor size, grade, and receptor status at diagnosis. The number of patients who completed neoadjuvant chemotherapy, surgery, and radiotherapy did not differ by race (84% of Caucasians vs 86.7% of African Americans) nor did the median length of time to complete trimodality treatment (263 [range, 207-422] days for Caucasians vs 262 [range, 165-371] days for African Americans). There was a trend toward slightly higher pathological complete response rates in Caucasian than African American women (20% in Caucasians vs 6.7% in African Americans, P ¼ .23). Despite slightly better response rates to neoadjuvant chemotherapy, Caucasian patients did not have higher 3-year local control rates (70% in Caucasians vs 64% in African Americans, P ¼ .73). However, there was a trend toward higher 3-year overall survival in Caucasian versus

Inflammatory Breast Neoplasms: A Systematic Review

“…Only three of the study samples 5,20,25 investigated determining features of the disease. For Andicet al 5 , no difference was assessed between races at middle age, tumour size and receptor grade and status.…”

“…For Andicet al 5 , no difference was assessed between races at middle age, tumour size and receptor grade and status. However, a trend emerged for pathologic response, which was slightly higher in Caucasian than in Afro-American women (P = 0,23) -a generally higher survival rate (three years) in Caucasian than in Afro-American women (P = 0,09) and higher survival rate of distant metastasis (P = 0,19).…”

“…Two studies 5,20 suggest that low socioeconomic status is associated with higherIBC incidence, irrespective of a patient's age/race/ethnic group at diagnosis, and possibly associated with lower educational level and poor access to health services.…”

“…With an average survival rate of three years, IBC accounts for about 2.5% of all breast cancer types in the US. IBC tends to develop at a younger age than the more common form of breast cancer 5 . Distinct signs and symptoms develop quickly and include redness, thickening (edema/swelling) and ridging or orange-peel like textureof the skin -peaud'orange 4 in French.…”

“…In the past two decades, a multi-therapy approach has increased the rates of clinical response through neoadjuvant chemotherapy, particularly usinganthracyclinesand taxanes-based combination, surgery, radiotherapy and hormonebased therapy 5 .…”