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Overall survival differences between patients with inflammatory and noninflammatory breast cancer presenting with distant metastasis at diagnosis

  • Epidemiology
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An Erratum to this article was published on 20 June 2015

Abstract

Inflammatory breast cancer (IBC) is a rare and aggressive disease. Previous studies have shown that among patients with stage III breast cancer, IBC is associated with a worse prognosis than noninflammatory breast cancer (non-IBC). Whether this difference holds true among patients with stage IV breast cancer has not been studied. We tested the hypothesis that overall survival (OS) is worse in patients with IBC than in those with non-IBC among patients with distant metastasis at diagnosis (stage IV disease). We reviewed the records of 1504 consecutive patients with stage IV breast cancer (IBC: 206; non-IBC: 1298) treated at our institution from 1987 through 2012. Survival curves for IBC and non-IBC subcohorts were compared. The Cox proportional hazards model was used to determine predictors of OS. The median follow-up period was 4.7 years. IBC was associated with shorter median OS time than non-IBC (2.27 vs. 3.40 years; P = 0.0128, log-rank test). In a multicovariate Cox model that included 1389 patients, the diagnosis of IBC was a significant independent predictor of worse OS (hazard ratio = 1.431, P = 0.0011). Other significant predictors of worse OS included Black (vs. White) ethnicity, younger age at diagnosis, negative HER2 status, and visceral (vs. nonvisceral) site of metastasis. IBC is associated with shorter OS than non-IBC in patients with distant metastasis at diagnosis. The prognostic impact of IBC should be taken into consideration among patients with stage IV breast cancer.

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Acknowledgments

This work was supported in part by a State of Texas Rare and Aggressive Breast Cancer Research Program grant; the National Institutes of Health/National Cancer Institute under award number P30CA016672, which supports the Biostatistics Shared Resource; and grant R01CA07466 from the National Cancer Institute (to Y.S.). We thank Jie Willey, MSN, and Mr. Limin Hsu of the Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, for their role in the preparation of this protocol and data management and Stephanie Deming of the Department of Scientific Publications, MD Anderson, for editing this manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Tamer M. Fouad, Takahiro Kogawa, Hiroko Masuda, Mariana Chavez-MacGregor, Ricardo H. Alvarez, Banu Arun, Vicente Valero & Naoto T. Ueno

  2. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Diane D. Liu & Yu Shen

  3. Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Randa El-Zein

  4. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Wendy A. Woodward & Thomas A. Buchholz

  5. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Anthony Lucci & Gildy Babiera

  6. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Savitri Krishnamurthy

  7. Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Tamer M. Fouad, Takahiro Kogawa, Hiroko Masuda, Randa El-Zein, Wendy A. Woodward, Mariana Chavez-MacGregor, Ricardo H. Alvarez, Anthony Lucci, Savitri Krishnamurthy, Vicente Valero & Naoto T. Ueno

  8. Department of Medical Oncology, The National Cancer Institute, Cairo University, Cairo, Egypt

    Tamer M. Fouad

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  1. Tamer M. Fouad
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  2. Takahiro Kogawa
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  16. Naoto T. Ueno
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Correspondence to Naoto T. Ueno.

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Fouad, T.M., Kogawa, T., Liu, D.D. et al. Overall survival differences between patients with inflammatory and noninflammatory breast cancer presenting with distant metastasis at diagnosis. Breast Cancer Res Treat 152, 407–416 (2015). https://doi.org/10.1007/s10549-015-3436-x

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  • DOI: https://doi.org/10.1007/s10549-015-3436-x

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