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Low Rates of Local-Regional Recurrence Among Inflammatory Breast Cancer Patients After Contemporary Trimodal Therapy

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

Abstract

Background

Inflammatory breast cancer (IBC) represents a rare (2–3 %) but aggressive subset of breast cancer with a historically reported 5-year overall survival rate of 50 % and a 3-year local-regional recurrence (LRR) rate of 20 %. This study aimed to evaluate long-term LRR in a contemporary cohort of non-metastatic IBC patients undergoing trimodal therapy at a single institution and identify factors associated with local and distant failure.

Methods

The study identified 262 patients with non-metastatic IBC who received trimodal therapy (neoadjuvant chemotherapy, modified radical mastectomy, adjuvant radiation) from an institutional prospective database (2007–2019). Long-term outcomes of local-regional and distant metastasis were reported. Survival outcomes were analyzed using the Cox proportional hazards regression model.

Results

The median age at diagnosis was 52 years, and the median follow-up period was 5.1 years. In this cohort, 82 (31.3 %) patients achieved a pathologic complete response (pCR) in the breast and axilla. Local-regional recurrence was observed in 18 (6.9 %) patients (11 isolated to the chest wall, 4 isolated to regional nodes, and 3 involving chest wall and ipsilateral axillary nodes). Distant metastasis was observed in 92 (35.1 %) patients. During the follow-up period, 90 deaths occurred. In the multivariate analysis, pCR was associated with improved disease-free survival (hazard ratio [HR], 0.26; 95 % confidence interval [CI], 0.13–0.51; p = 0.001) and overall survival (HR, 0.31; 95 % CI, 0.15–0.65; p = 002).

Conclusions

During a median follow-up period longer than 5 years, the local-regional relapse rate for the IBC patients treated with contemporary trimodal therapy was 6.9%, similar to that for the non-IBC patients. After chemotherapy, surgical resection with modified radical mastectomy to negative margins and postmastectomy radiation therapy resulted in excellent long-term local-regional control.

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Acknowledgment

The institutional database is supported by Morgan Welch Inflammatory Breast Cancer Research Program, and a State of Texas Rare and Aggressive Breast Cancer Research Program Grant.

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Authors and Affiliations

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

    Taiwo Adesoye MD, MPH, Shlermine Everidge MD, Susie X. Sun MD, MS, Mediget Teshome MD, MPH, FACS & Anthony Lucci MD, FACS

  2. Department of Surgery, Baylor College of Medicine, Houston, TX, USA

    Jennifer Chen MD

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

    Susie X. Sun MD, MS, Mediget Teshome MD, MPH, FACS, Vicente Valero MD, FACP, Wendy A. Woodward MD, PhD & Anthony Lucci MD, FACS

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

    Vicente Valero MD, FACP

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

    Wendy A. Woodward MD, PhD

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  1. Taiwo Adesoye MD, MPH
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  2. Shlermine Everidge MD
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Correspondence to Taiwo Adesoye MD, MPH.

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Wendy Woodward is a consultant for Exact Sciences/Genomic Health and Epic Sciences. The remaining authors have no conflicts of interest.

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Adesoye, T., Everidge, S., Chen, J. et al. Low Rates of Local-Regional Recurrence Among Inflammatory Breast Cancer Patients After Contemporary Trimodal Therapy. Ann Surg Oncol 30, 6232–6240 (2023). https://doi.org/10.1245/s10434-023-13906-5

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