Outcomes of patients with inflammatory breast cancer treated by breast-conserving surgery.

Abstract

Inflammatory breast cancer (IBC) is rare and associated with a poor prognosis. Following neoadjuvant chemotherapy or endocrine therapy, the multidisciplinary team selected a small number of patients for breast-conservation therapy (BCT). The aim of this study was to determine the outcome of IBC patients treated with BCT in Edinburgh. Between January 1999 and December 2013, thirty-five women with IBC were treated by BCT. The median follow-up was 80months. The 5-year actuarial survival for the 35 patients was 70.3%. Median survival for 20 neoadjuvant chemotherapy patients was 12.9years (95% CI 7.6, 18.1), and for 14 patient neoadjuvant endocrine therapy patients, it was 11.8years (95% CI 1.1, 22.6) (p=0.34). Five patients developed locoregional recurrence (LRR) between 11 and 72months after BCT (median 37months). Three had breast only recurrence, one patient had both breast and axillary recurrence, and one developed axillary recurrence. The 5-year LR-free survival was 87.5% (95% CI 76.0, 99.0). In 4 of the 5 patients with LRR, systemic metastases were diagnosed within 6months and survival post-LRR in these 4 patients was short. IBC is not an absolute contraindication to BCT. LRR in patients after BCT appears part of widespread recurrent disease rather than inadequate local treatment. Multicentre data should be collected to confirm that women with IBC who have a good response to systemic therapy may be offered BCT in the knowledge that in a larger series our observations are confirmed.