Abstract
Inflammatory breast cancer (IBC) is the most aggressive and deadly form of breast cancer. The peculiar clinical presentation and relative low incidence compared with non-IBC breast cancer contributes to delays in diagnoses and, consequently, to the dismal prognosis of these patients. Moreover, the etiology and pathogenesis of IBC remain largely unknown and there are currently no approved treatments for this disease. With these premises, we felt there were compelling reasons to convene a meeting solely dedicated to IBC. In December 2008, the first International Inflammatory Breast Cancer Conference, organized by an international committee of expert physicians and scientists and hosted by The University of Texas M.D. Anderson Cancer Center, was held inHouston, Texas. An international group of nearly 300 healthcare professionals, researchers, and patient advocates from 17 countries gathered to participate in the day and a half conference. Fifty posters were presented representing the leading edge of epidemiological studies and clinical and basic science research. This supplement of the Cancer Journal gathers the scientific contributions presented by the participants at the meetings that were organized with the scope of 1) providing an in-depth overview of the disease for educational purposes and 2) highlighting new research findings. The manuscripts are presented in the sequence discussed at the meeting. The first session was devoted to summarizing the current understanding of IBC epidemiology. The disease has previously been reported to comprise up to 20% of new cases in Tunisia and North Africa, and Dr. Boussen’s manuscript reviews the data and hypothesis supporting such claims. Furthermore, we review the incidence in the Mediterranean regions and discuss the supporting data for viral etiopathogenetic hypotheses. Moreover, we open the debate related to the contribution of an ambiguous IBC definition to the proper classification in large databases such as the Tumor Registries. The subsequent section deals with the important aspects of clinical and pathological diagnosis and procedures used to support the most appropriate steps for tissue collections and pathological review. This subject introduces the current understanding of the peculiar biological features of IBC supported by data from gene profiling and biomarker analyses, some of which highlight the potential for IBC as a disease in which cancer stem cells represent a predominant population. The therapeutic approaches associated with this feature support the development of more effective targeted therapies. The data frommost recent research findings are presented as additional evidence of possible alternative therapeutic opportunities. Finally, we discuss the role of appropriate locoregional therapy (surgery and radiotherapy) in themultidisciplinarymanagement of the disease. In summary, we hope these proceedings can provide a valuable educational source for every clinical investigator that deals with women with breast cancer. In addition, several research topics have the potential to attract interest of bench investigators to improve the current understanding of the disease. We have not included in these proceedings the testimonials of IBC survivors and advocates that made the IBC conference unique and meaningful. They remain a constant reminder of the urgency of the work and the need for dedicated resources that will allow us to finally understand and cure this deadly disease.
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