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

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Conflicts of interest

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Author information

Authors and Affiliations

  1. Harvard Radiation Oncology Program, Boston, MA, USA

    Laura E. G. Warren MD, EdM

  2. Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA

    Hao Guo MS & Meredith M. Regan ScD

  3. Department of Surgery, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, USA

    Faina Nakhlis MD

  4. Division of Breast Imaging, Department of Radiology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, USA

    Eren D. Yeh MD

  5. Division of Nuclear Medicine, Department of Radiology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, USA

    Heather A. Jacene MD

  6. Department of Medical Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, USA

    Judi Hirshfield-Bartek RN & Beth A. Overmoyer MD

  7. Department of Radiation Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, USA

    Jennifer R. Bellon MD

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  1. Laura E. G. Warren MD, EdM
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  2. Hao Guo MS
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  3. Meredith M. Regan ScD
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  4. Faina Nakhlis MD
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Correspondence to Jennifer R. Bellon MD.

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Warren, L.E.G., Guo, H., Regan, M.M. et al. Inflammatory Breast Cancer: Patterns of Failure and the Case for Aggressive Locoregional Management. Ann Surg Oncol 22, 2483–2491 (2015). https://doi.org/10.1245/s10434-015-4469-4

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  • DOI: https://doi.org/10.1245/s10434-015-4469-4

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