Erschienen in:
21.07.2023 | Breast Oncology
Low Rates of Local-Regional Recurrence Among Inflammatory Breast Cancer Patients After Contemporary Trimodal Therapy
verfasst von:
Taiwo Adesoye, MD, MPH, Shlermine Everidge, MD, Jennifer Chen, MD, Susie X. Sun, MD, MS, Mediget Teshome, MD, MPH, FACS, Vicente Valero, MD, FACP, Wendy A. Woodward, MD, PhD, Anthony Lucci, MD, FACS
Erschienen in:
Annals of Surgical Oncology
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Ausgabe 10/2023
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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.