Lymph node status in inflammatory breast cancer
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Positive lymph node status in breast cancer is known to be an adverse prognostic factor, but the effect of lymph node (LN) status in inflammatory breast cancer (IBC) has not been evaluated. This study was designed to investigate the association between lymph node status and overall survival (OS) in individuals with IBC. Using the Surveillance, Epidemiology, and End Results (SEER) 18 registry, we collected data on 761 patients diagnosed with non-metastatic IBC from 2004 to 2008. Survival analysis was performed using the Kaplan–Meier method. Cox proportional hazard regression was performed to evaluate univariate and multivariate associations between estrogen and progesterone receptor (ER/PR) status, treatment, and OS. Positive nodal status was associated with a significant decrease in OS (p < 0.001). Five-year survival for LN-positive and LN-negative patients was 49 and 66 %, respectively. In node-positive patients, ER or PR positivity was associated with improved OS, (p = 0.025, p = 0.007). In node-positive patients, the combination of surgery and radiation therapy improved OS when compared with surgery alone (p = 0.002). Nearly 80 % of the patients in this study had nodal metastasis. Positive nodal status was found to be an adverse prognostic factor. ER/PR positivity and treatment with surgery and radiation in node-positive patients was found to improve outcomes. Further studies are required to characterize the biology of IBC and guide the optimal treatment of this disease.
KeywordsInflammatory breast cancer IBC SEER Lymph node Estrogen receptor Progesterone receptor Overall survival
This project was supported in part by SC CTSI (NIH/NCATS) through Grant UL1TROOO130 and P30CA014089 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institute of Health.
Conflict of interest
The authors declare that they have no conflict of interest.
- 4.Zell JA, Tsang WY, Taylor TH et al (2009) Prognostic impact of human epidermal growth factor-like receptor 2 and hormone receptor status in inflammatory breast cancer (IBC): analysis of 2,014 IBC patient cases from the California Cancer Registry. Breast Cancer Res 11(1):R9. doi: 10.1186/bcr2225 CrossRefPubMedCentralPubMedGoogle Scholar
- 7.Chang S, Parker SL, Pham T et al (1998) Inflammatory breast carcinoma incidence and survival: the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute, 1975–1992. Cancer 82(12):2366–2372. doi: 10.1002/(sici)1097-0142(19980615)82:12<2366:aid-cncr10>3.0.co;2-n CrossRefPubMedGoogle Scholar
- 13.Surveillance, Epidemiology, and End Results (SEER) Program ( http://www.seer.cancer.gov ) SEER*Stat Database: Incidence - SEER 9 Regs Research Data, Nov 2011 Sub (1973–2009) <Katrina/Rita Population Adjustment> - Linked To County Attributes - Total U.S., 1969–2010 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2012, based on the November 2011 submission
- 15.Schwartz GF, Birchansky CA, Komarnicky LT et al (1994) Induction chemotherapy followed by breast conservation for locally advanced carcinoma of the breast. Cancer 73(2):362–369. doi: 10.1002/1097-0142(19940115)73:2<362:aid-cncr2820730221>3.0.co;2-l CrossRefPubMedGoogle Scholar
- 19.EBCTCG (Early Breast Cancer Trialists’ Collaborative Group) (2014) Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet 383(9935):2127–2135. doi: 10.1016/s0140-6736(14)60488-8 CrossRefGoogle Scholar
- 25.Dawood S, Cristofanilli M (2011) Inflammatory breast cancer: what progress have we made? Oncol NY 25(3):264–273Google Scholar
- 26.Gianni L, Eiermann W, Semiglazov V et al (2010) Neoadjuvant chemotherapy with trastuzumab followed by adjuvant trastuzumab versus neoadjuvant chemotherapy alone, in patients with HER2-positive locally advanced breast cancer (the NOAH trial): a randomised controlled superiority trial with a parallel HER2-negative cohort. Lancet 375(9712):377–384. doi: 10.1016/S0140-6736(09)61964-4 CrossRefPubMedGoogle Scholar