Abstract
BackgroundPrevious studies have reported poor survival rates in inflammatory breast cancer (IBC) patients than non-inflammatory local advanced breast cancer (non-IBC) patients. However, until now, the survival rate of IBC and other T4 non-IBC (T4-non-IBC) patients remains unexplored.MethodsSurveillance, Epidemiology, and End Results (SEER) database was searched to identify cases with confirmed non-metastatic IBC and T4-non-IBC who had received surgery, chemotherapy, and radiotherapy between 2010 and 2015. IBC was defined as per the American Joint Committee on Cancer (AJCC) 7th edition. Breast Cancer-Specific Survival (BCSS) was estimated by plotting the Kaplan-Meier curve and compared across groups by using the log-rank test. Cox model was constructed to determine the association between IBC and BCSS after adjusting for age, race, stage of disease, tumor grade and surgery type.ResultsOut of a total of 1986 patients, 37.1% had IBC and mean age was 56.6 ± 12.4. After a median follow-up time of 28 months, 3-year BCSS rate for IBC and T4-non-IBC patients was 81.4 and 81.9%, respectively (log-rank p = 0.398). The 3-year BCSS rate in HR−/HER2+ cohort was higher for IBC patients than T4-non-IBC patients (89.5% vs. 80.8%; log-rank p = 0.028), and in HR−/HER2- cohort it was significantly lower for IBC patients than T4-non-IBC patients (57.4% vs. 67.5%; log-rank p = 0.010). However, it was identical between IBC and T4-non-IBC patients in both HR+/HER2- (85.0% vs. 85.3%; log-rank p = 0.567) and HR+/HER2+ (93.6% vs. 91.0%, log-rank p = 0.510) cohorts. After adjusting for potential confounding variables, we observed that IBC is a significant independent predictor for survival of HR−/HER2+ cohort (hazards ratio [HR] = 0.442; 95% CI: 0.216–0.902; P = 0.025) and HR−/HER2- cohort (HR = 1.738; 95% CI: 1.192–2.534; P = 0.004).ConclusionsPatients with IBC and T4-non-IBC had a similar BCSS in the era of modern systemic treatment. In IBC patients, the HR−/HER2+ subtype is associated with a better outcome, and HR−/HER2- subtype is associated with poorer outcomes as compared to the T4-non-IBC patients.
Highlights
Previous studies have reported poor survival rates in inflammatory breast cancer (IBC) patients than non-inflammatory local advanced breast cancer patients
Patient baseline characteristics A total of 1986 patients with non-metastatic T4 breast cancer who were enrolled in the SEER database between January 2010 till December 2015 were included in this study
The outcome indicated that most of the Inflammatory breast cancer (IBC) patients were younger during the onset of presentation, white people, high histological grade, HER2-positive, ER- and PR-negative than non-IBC patients; the cases in both groups showed similar clinical-staging
Summary
Previous studies have reported poor survival rates in inflammatory breast cancer (IBC) patients than non-inflammatory local advanced breast cancer (non-IBC) patients. Inflammatory breast cancer (IBC) is a rare and fatal form of breast cancer. It accounts for only 2–5% of all newly. Until now, no specific diagnostic biomarker is available to differentiate these cancer types, except for the Tumor-Node-Metastasis (TNM) classification system. The multidisciplinary therapeutic regimen of breast cancer primarily includes neoadjuvant chemotherapy, surgery, radiotherapy, and hormone therapy. It substantially improves the survival rate of patients with IBC and nonIBC. A recent study reported, 71 and 31%, 5 and 10 year OS rates, respectively, in IBC patients [5] [6]
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