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Long-term Oncologic Outcomes in Patients with Inflammatory Breast Cancer with Supraclavicular Nodal Involvement

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

Abstract

Background

Inflammatory breast cancer (IBC) is a rare and aggressive subtype of breast cancer characterized by rapid progression and early metastasis, often with advanced nodal locations, including the supraclavicular (SCV) nodal basin. Previously considered M1 disease, ipsilateral clinical supraclavicular node involvement (N3c) disease is now considered locally advanced disease and warrants treatment with intent to cure. The objective of this study was to evaluate the long-term outcomes of patients with IBC and N3c disease.

Patients and Methods

This study was conducted using a prospectively collected database of all patients with IBC treated at a dedicated cancer center from 2007 to 2019. Surgical patients with SCV nodal involvement and complete follow-up were identified. Our primary outcome was 5-year overall survival (OS). Multivariate Cox proportional hazards models were used to determine predictors for survival. Event-free survival (EFS) and OS were calculated using the Kaplan–Meier method.

Results

There were 70 patients who met inclusion criteria. All patients underwent comprehensive trimodality therapy. The majority of patients had complete (66.2%) radiologic response in the SCV nodal basins following neoadjuvant therapy. Six patients (8.6%) had a locoregional recurrence, with two (2.9%) occurring in the supraclavicular fossa. The 5-year OS was 60.2% [95% confidence interval (CI) 47.7–72.7%]. Increasing age (hazard ratio 2.7; p = 0.03) and triple-negative subtype (hazard ratio 4.9; p = 0.03) were associated with poor OS. The 5-year EFS was 56.1% (95% CI 40.9–68.8%). The presence of more than ten positive axillary nodes on final surgical pathology (hazard ratio 5.5; p = 0.01) predicted poor EFS.

Conclusions

With comprehensive trimodality therapy and multidisciplinary team approach, patients with IBC with supraclavicular nodal involvement experience excellent locoregional control and favorable survival.

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Acknowledgement

Institutional database supported by Morgan Welch Inflammatory Breast Cancer Research Program and the State of Texas Rare and Aggressive Breast Cancer Research Program Grant.

Funding

Wendy Woodward, Epic Science (honorarium), Exact Science (honorarium), Physicians Education Resource (honorarium).

Author information

Authors and Affiliations

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

    Adrienne N. Cobb MD, MS, Mediget Teshome MD, MPH, Anthony Lucci MD, Henry M. Kuerer MD, PhD & Susie X. Sun MD

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

    Kevin Diao MD, Michael Stauder MD & Wendy A. Woodward MD

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

    Naoto T. Ueno MD, PhD & Rachel M. Layman MD

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

    Mediget Teshome MD, MPH, Anthony Lucci MD, Naoto T. Ueno MD, PhD, Michael Stauder MD, Rachel M. Layman MD, Wendy A. Woodward MD & Susie X. Sun MD

Authors
  1. Adrienne N. Cobb MD, MS
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Correspondence to Susie X. Sun MD.

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Wendy Woodward, Epic Science (honorarium), Exact Science (honorarium), Physicians Education Resource (honorarium).

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Cobb, A.N., Diao, K., Teshome, M. et al. Long-term Oncologic Outcomes in Patients with Inflammatory Breast Cancer with Supraclavicular Nodal Involvement. Ann Surg Oncol 29, 6381–6392 (2022). https://doi.org/10.1245/s10434-022-12144-5

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