Inflammatory breast cancer in Morocco: Experience of Hassan II University Hospital.

Abstract

e11516 Background: Inflammatory breast cancer (IBC) is the most virulent type of breast cancer. It represents 1 to 6% of all the breast cancer in Western countries. It is speculated that the incidence of IBC is greater in emerging countries especially in North Africa. The management of this disease requires a multidisciplinary. Methods: We recorded the cases of 80 patients with IBC admitted in the Medical Oncology Unit between January 2007 and August 2011. We included patients with IBC classified as T4d using criteria based on the tumor-node-metastasis (TNM) classification . The aims of this study is to evaluate the epidemiological, clinical, histopathological and therapeutic aspects of this disease. Results: The median age of our patients was 44.5 years ranged from 24 to 88 years. The incidence of IBC in our study was 7.8%. The lymph node involvement was noted in 60% distributed as following: N0 in 40%, N1 in 30%, N2 in 19%, N3 in 11%. For histology, ductal carcinoma represents 96% of all cases. Human epithelial receptor 2 (HER 2) was positive in 32% of the cases. Hormonal receptors were negative in 22% of the cases. The grade of the tumor according to the Scarff Bloom Richardson classification was as following: grade I ( 2.5%), grade II (52%), grade III (45.5%). All patients received neoadjuvant chemotherapy. 45% received chemotherapy with anthracyclines, 35% were treated with docetaxel and anthracycline and 10% with the association chemotherapy Trastuzumab. According to RECIST classification, a partial or total clinical response was noted in 80% of cases, 10% of patients had stability, and 10% clinical progression. According to Sattalof classification, a histological response greater than 50% in the tumor (TB) was noted in 45%. A complete pathological response (TANA or TANB) was obtained in 15% of cases. After a median follow up of 2 years 35% of the patients had a metastatic or locoregional reccurence, 45% of the cases remain in complete remission. Conclusions: The result of our study is concordant with the litterature. The incidence of IBC was greater than the incidence in western countries. The IBC was also associated with high grade and younger age. Despite a good clinical and pathological response to chemotherapy, outcomes were poor.