Modern outcomes of inflammatory breast cancer.

Title

Modern outcomes of inflammatory breast cancer.

Creator

Rehman S; Reddy CA; Tendulkar RD; Rehman Sana; Reddy Chandana A; Tendulkar Rahul D

Publisher

International Journal of Radiation Oncology, Biology, Physics

Date

2012
2012-11

Description

Purpose: To report contemporary outcomes for inflammatory breast cancer (IBC) patients treated in the modern era of trastuzumab and taxane-based chemotherapy. Methods and Materials: We retrospectively reviewed the charts of 104 patients with nonmetastatic IBC treated between January 2000 and December 2009. Patients who received chemotherapy, surgery, and radiation therapy were considered to have completed the intended therapy. Kaplan-Meier curves estimated locoregional control (LRC), distant metastases-free survival (DMFS), and overall survival. Results: The median follow-up time was 34 months; 57 (55%) patients were estrogen receptor progesterone receptor (ER/PR) negative, 34 (33%) patients were human epidermal growth factor receptor 2 (her2)/neu amplified, and 78 (75%) received definitive postoperative radiation. Seventy-five (72%) patients completed all of the intended therapy, of whom 67 (89%) received a taxane and 18/28 (64%) of her2/neu-amplified patients received trastuzumab. For the entire cohort, the 5-year rates of overall survival, LRC, and DMFS were 46%, 83%, and 44%, respectively. The ER/PR-negative patients had a 5-year DMFS of 39% vs. 52% for ER/PR-positive patients (p = 0.03). The 5-year DMFS for patients who achieved a pathologic complete response compared with those who did not was 83% vs. 44% (p \textless 0.01). Those patients who received \textgreater60.4 Gy (n = 15) to the chest wall had a 5-year LRC rate of 100% vs. 83% for those who received 45 to 60.4 Gy (n = 49; p = 0.048). On univariate analysis, significant predictors of DMFS included achieving a complete response to neoadjuvant chemotherapy (hazard ratio [HR] = 5.8; 95% confidence interval [CI] = 1.4-24.4; p = 0.02) and pathologically negative lymph nodes (HR = 4.1; 95% CI = 1.4-11.9; p \textless 0.01), but no factor was significant on multivariate analysis. Conclusions: For IBC patients, the rate of distant metastases is still high despite excellent local control, particularly for patients who received \textgreater60.4 Gy to the chest wall. Despite the use of taxanes and trastuzumab, outcomes remain modest, particularly for those with ER/PR-negative disease and those without a pathologic complete response.

Subject

Adult; Female; Aged; Survival; Radiation Dosage; Antibodies; Human; Middle Age; Retrospective Design; Receptors; Hydrocarbons; Treatment Outcomes; Breast Neoplasms; 80 and Over; Antineoplastic Agents – Therapeutic Use; Breast Neoplasms – Mortality; Breast Neoplasms – Pathology; Monoclonal – Therapeutic Use; Breast Neoplasms – Therapy; Cell Surface – Analysis; Combined Modality Therapy – Methods; Cyclic – Therapeutic Use; Hydrocarbons – Therapeutic Use; Lumpectomy – Statistics and Numerical Data; Proteins – Analysis

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

619–624

Issue

3

Volume

84

Citation

Rehman S; Reddy CA; Tendulkar RD; Rehman Sana; Reddy Chandana A; Tendulkar Rahul D, “Modern outcomes of inflammatory breast cancer.,” NEOMED Bibliography Database, accessed February 26, 2021, https://neomed.omeka.net/items/show/5957.

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