Annals of Surgical Oncology

, Volume 22, Issue 8, pp 2483–2491 | Cite as

Inflammatory Breast Cancer: Patterns of Failure and the Case for Aggressive Locoregional Management

  • Laura E. G. Warren
  • Hao Guo
  • Meredith M. Regan
  • Faina Nakhlis
  • Eren D. Yeh
  • Heather A. Jacene
  • Judi Hirshfield-Bartek
  • Beth A. Overmoyer
  • Jennifer R. Bellon
Breast Oncology

Abstract

Background

Inflammatory breast cancer (IBC) is a rare and aggressive subtype. This study analyzes the patterns of failure in patients with IBC treated at our institution.

Methods

We retrospectively analyzed the records of 227 women with IBC presenting between 1997 and 2011. Survival analysis was used to calculate overall survival (OS) and disease-free survival. Competing risk analysis was used to calculate locoregional recurrence (LRR).

Results

A total of 173 patients had locoregional-only disease at presentation (non-MET). Median follow-up in the surviving patients was 3.3 years. Overall, 132 (76.3 %) patients received trimodality therapy with chemotherapy, surgery, and radiotherapy. Three-year OS was 73.1 % [95 % confidence interval (CI) 64.9–82.4]. Cumulative LRR was 10.1, 16.9, and 21.3 % at 1, 2, and 3 years, respectively. No variable was significantly associated with LRR. Fifty-four patients had metastatic disease at presentation (MET). Median follow-up in the surviving patients was 2.6 years. Three-year OS was 44.3 % (95 % CI 31.4–62.5). Twenty-four (44.4 %) patients received non-palliative local therapy (radiotherapy and/or surgery). For these patients, median OS after local therapy was 2 years. Excluding six patients who received local therapy for symptom palliation, the crude incidence of locoregional progression or recurrence (LRPR) was 17 % (4/24) for those who received local therapy compared with 57 % (13/23) for those who did not.

Conclusions

For non-MET patients, LRR remains a problem despite trimodality therapy. More aggressive treatment is warranted. For MET patients, nearly 60 % have LRPR with systemic therapy alone. Local therapy should be considered in the setting of metastatic disease to prevent potential morbidity of progressive local disease.

Keywords

Overall Survival Inflammatory Breast Cancer Local Therapy Locally Advanced Breast Cancer Trimodality Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflicts of interest

None.

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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Laura E. G. Warren
    • 1
  • Hao Guo
    • 2
  • Meredith M. Regan
    • 2
  • Faina Nakhlis
    • 3
  • Eren D. Yeh
    • 4
  • Heather A. Jacene
    • 5
  • Judi Hirshfield-Bartek
    • 6
  • Beth A. Overmoyer
    • 6
  • Jennifer R. Bellon
    • 7
  1. 1.Harvard Radiation Oncology ProgramBostonUSA
  2. 2.Department of Biostatistics and Computational BiologyDana-Farber Cancer InstituteBostonUSA
  3. 3.Department of SurgeryBrigham and Women’s Hospital and Dana-Farber Cancer InstituteBostonUSA
  4. 4.Division of Breast Imaging, Department of RadiologyBrigham and Women’s Hospital and Dana-Farber Cancer InstituteBostonUSA
  5. 5.Division of Nuclear Medicine, Department of RadiologyBrigham and Women’s Hospital and Dana-Farber Cancer InstituteBostonUSA
  6. 6.Department of Medical OncologyBrigham and Women’s Hospital and Dana-Farber Cancer InstituteBostonUSA
  7. 7.Department of Radiation OncologyBrigham and Women’s Hospital and Dana-Farber Cancer InstituteBostonUSA

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