Identifying the impact of inflammatory breast cancer on survival: a retrospective multi-center cohort study

• Published in: Archives of gynecology and obstetrics Vol. 292; no. 3; pp. 655 - 664
• Main Authors: Diessner, J., Van Ewijk, R., Weiss, C. R., Janni, W., Wischnewsky, M. B., Kreienberg, R., Hancke, K., Blettner, M., Wöckel, A., Schwentner, L.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2015; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Breast cancer; Cohort analysis; Disease-Free Survival; Endocrinology; Female; Germany - epidemiology; Gynecologic Oncology; Gynecology; Human Genetics; Humans; Incidence; Inflammatory Breast Neoplasms - diagnosis; Inflammatory Breast Neoplasms - metabolism; Inflammatory Breast Neoplasms - mortality; Kaplan-Meier Estimate; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Neoplasm Recurrence, Local; Neoplasm Staging; Obstetrics/Perinatology/Midwifery; Prevalence; Prognosis; Proportional Hazards Models; Receptor, ErbB-2 - metabolism; Receptors, Estrogen - metabolism; Receptors, Progesterone - metabolism; Retrospective Studies; Germany; Inflammatory breast cancer; Overall survival; Hormone receptor expression; BRENDA; Her2 Expression
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-015-3691-4

Purpose
Inflammatory breast cancer (IBC) represents a rare and aggressive form of cancer with negative prognosis and high rate of recurrence. The purpose of this retrospective multi-center study was to evaluate the effect of IBC on overall and disease-free survival. Furthermore we analyzed the influence of hormone and Her2 receptor expression on inflammatory breast cancer cells on the clinical outcome of patients.
Methods
This retrospective German multi-center study included 11,780 patients with primary breast cancer recruited from 1992 to 2008. In this sub-group analysis we focused on 70 patients with IBC.
Results
Despite the relatively small sample size, we could confirm the aggressiveness of inflammatory breast cancer and the different clinical behavior of IBC subtypes. It could be demonstrated that the lack of expression of hormone receptors on tumor cells is associated with a more aggressive clinical course and decreased overall and disease-free survival. Higher incidence of Her2 overexpression, that is typically associated with poor prognostic outcome among women with non-IBC tumors, seems however to have no prognostic significance.
Conclusions
This BRENDA sub-group analysis, on a German cohort of breast cancer patients confirmed the negative outcome of IBC and the different clinical behavior of IBC subtypes. The best management of IBC requires intensive coordination and cooperation between various clinical disciplines involved in the treatment of IBC patients. Moreover there is a need to identify IBC-specific targeted therapies to improve the curing prospects of this subtype of cancer.