Improved Locoregional Control in a Contemporary Cohort of Nonmetastatic Inflammatory Breast Cancer Patients Undergoing Surgery.

Autor: Rosso KJ; Department of Breast Surgical Oncology, University of Texas, MD Anderson Cancer Center, 1400 Pressler Drive, Unit 1434, FCT 7.5046, Houston, TX, 77030, USA., Tadros AB; Department of Breast Surgical Oncology, University of Texas, MD Anderson Cancer Center, 1400 Pressler Drive, Unit 1434, FCT 7.5046, Houston, TX, 77030, USA., Weiss A; Department of Breast Surgical Oncology, University of Texas, MD Anderson Cancer Center, 1400 Pressler Drive, Unit 1434, FCT 7.5046, Houston, TX, 77030, USA., Warneke CL; Department of Biostatics, University of Texas, MD Anderson Cancer Center, Houston, TX, USA., DeSnyder S; Department of Breast Surgical Oncology, University of Texas, MD Anderson Cancer Center, 1400 Pressler Drive, Unit 1434, FCT 7.5046, Houston, TX, 77030, USA., Kuerer H; Department of Breast Surgical Oncology, University of Texas, MD Anderson Cancer Center, 1400 Pressler Drive, Unit 1434, FCT 7.5046, Houston, TX, 77030, USA., Ueno NT; Department of Breast Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, University of Texas, MD Anderson Cancer Center, Houston, TX, USA., Stecklein SR; Department of Radiation Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA., Woodward WA; Department of Radiation Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, University of Texas, MD Anderson Cancer Center, Houston, TX, USA., Lucci A; Department of Breast Surgical Oncology, University of Texas, MD Anderson Cancer Center, 1400 Pressler Drive, Unit 1434, FCT 7.5046, Houston, TX, 77030, USA. alucci@mdanderson.org.; Department of Surgical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA. alucci@mdanderson.org.; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, University of Texas, MD Anderson Cancer Center, Houston, TX, USA. alucci@mdanderson.org.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2017 Oct; Vol. 24 (10), pp. 2981-2988. Date of Electronic Publication: 2017 Aug 01.
DOI: 10.1245/s10434-017-5952-x
Abstrakt: Background: Inflammatory breast cancer (IBC) is an aggressive form of breast cancer characterized by rapid progression and early metastatic dissemination. The purpose of this study was to assess contemporary rates of local regional recurrence (LRR) in the era of trimodality therapy for nonmetastatic IBC and identify risk factors leading to local failure.
Methods: A total of 114 patients with nonmetastatic IBC receiving trimodality therapy (neoadjuvant chemotherapy, surgery, and radiation therapy) were identified from a prospectively collected database from 2007 to 2015 and outcomes analyzed.
Results: Median age at diagnosis was 52 years, and the median follow-up was 3.6 years. Sixty-three (55%) patients presented with N2 IBC, and 52 patients (45%) presented with N3 IBC. Local regional recurrence was observed during follow-up for four patients; 25 died, and 85 were censored at last follow-up. Surgical margins were negative in 99% of patients (n = 113). The 2-year probability of LRR was 3.19% (95% confidence interval 1.03-9.90%). Five-year overall survival for this cohort was 69.14%. Improvement in disease-free survival was seen among patients with HER2+ subtype, clinical stage IIIB, complete or partial radiologic response to neoadjuvant therapy, pathologic complete response, and lower nodal burden on presentation.
Conclusions: Locoregional recurrences were rare at a median of 3.6 years follow-up in a contemporary cohort of IBC patients treated with trimodality therapy. Although longer follow-up is needed, aggressive surgical resection to negative margins in the frame of trimodality therapy with curative intent can lead to LRR rates that mirror non-IBC rates.
Databáze: MEDLINE
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