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Modified Radical Mastectomy in De Novo Stage IV Inflammatory Breast Cancer

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

Abstract

Background

There are few studies on surgical management in patients with de novo metastatic inflammatory breast cancer (IBC). The objective of this study is to examine the association between modified radical mastectomy (MRM) and disease-specific survival (DSS) in patients with de novo stage IV IBC.

Patients and Methods

The Surveillance, Epidemiology, and End Result Program was queried for patients ≥18 years old with cT4d/pT4d pathology, histology type 8530 and 8533 with distant disease between 2010 and 2016. The sample was divided into two groups: (1) the MRM group, defined as MRM or mastectomy with at least ten lymph nodes removed, and (2) the no-surgery group. Sociodemographic and clinical variables were compared between the groups on bivariable analysis. After propensity score matching, Kaplan–Meier curves and a Cox proportional-hazards model examined DSS.

Results

1293 patients were included in the study, of whom 240 underwent MRM. A higher percentage in the MRM group had only one metastatic site (69.8% versus 52.2%), received chemotherapy (88.3% versus 66.1%) and radiation (58.8% versus 26.0%) compared with the no-MRM group. MRM was associated with an increase in DSS compared with no MRM [HR 0.63 (95% CI 0.50–0.80), p < 0.001]. Patients with MRM had a 5-year DSS rate of 31.4% compared with 17.7% for patients not undergoing surgery (p = 0.001). Survival time was 38 months (range 27–45 months) for the MRM group versus 27 months (22–29 months) for the no-MRM group.

Conclusion

MRM in patients with de novo metastatic IBC may improve DSS in a subset of patients.

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Acknowledgement

Samilia Obeng-Gyasi is funded by the Paul Calabresi Career Development Award (K12 CA133250).

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA

    J. C. Chen MD, Allan Tsung MD & Samilia Obeng-Gyasi MD, MPH

  2. Department of Biomedical Informatics, University of Pittsburg, Pittsburg, PA, USA

    Yaming Li MD, MS

  3. The Ohio State University College of Medicine, Columbus, OH, USA

    James L. Fisher PhD

  4. The Ohio State University Wexner Medical Center, James Cancer Hospital and Solove Research Institute, Columbus, OH, USA

    James L. Fisher PhD, Allan Tsung MD, Jose G. Bazan MD & Samilia Obeng-Gyasi MD, MPH

  5. Department of Economics, Indiana University Purdue University, Indianapolis, IN, USA

    Oindrila Bhattacharyya MSc

  6. The William Tierney Center for Health Services Research, Regenstrief Institute, Inc, Indianapolis, IN, USA

    Oindrila Bhattacharyya MSc

  7. Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA

    Jose G. Bazan MD

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  1. J. C. Chen MD
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Chen, J.C., Li, Y., Fisher, J.L. et al. Modified Radical Mastectomy in De Novo Stage IV Inflammatory Breast Cancer. Ann Surg Oncol 29, 6681–6688 (2022). https://doi.org/10.1245/s10434-022-11975-6

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