Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
Ann Oncol. 2012 Apr;23(4):870-5. doi: 10.1093/annonc/mdr319. Epub 2011 Jul 15.
The objective of this retrospective study was to determine factors impacting survival among women with inflammatory breast cancer (IBC).
The Surveillance, Epidemiology and End Results Registry (SEER) was searched to identify women with stage III/IV IBC diagnosed between 2004 and 2007. IBC was identified within SEER as T4d disease as defined by the sixth edition of the American Joint Committee on Cancer. The Kaplan-Meier product-limit method was used to describe inflammatory breast cancer-specific survival (IBCS). Cox models were fitted to assess the multivariable relationship of various patient and tumor characteristics and IBCS.
Two thousand three hundred and eighty-four women with stage IIIB/C and IV IBC were identified. Two-year IBCS among women with stage IIIB, IIIC and IV disease was 81%, 67% and 42%, respectively (P < 0.0001). In the multivariable model, patients with stage IIIB disease and those with stage IIIC disease had a 63% [hazard ratio (HR) 0.373, 95% confidence interval (CI) 0.296-0.470, P < 0.001] and 31% (HR 0.691, 95% CI 0.512-0.933, P = 0.016) decreased risk of death from IBC, respectively, compared with women with stage IV disease. Other factors significantly associated with decreased risk of death from IBC included low-grade tumors, being of white/other race, undergoing surgery, receiving radiation therapy and hormone receptor-positive disease. Among women with stage IV disease, those who underwent surgery of their primary had a 51% decreased risk of death compared with those who did not undergo surgery (HR = 0.489, 95% CI 0.339-0.704, P < 0.0001).
Although IBC is an aggressive subtype of locally advanced breast cancer, it is heterogeneous with various factors affecting survival. Furthermore, our results indicate that a subgroup of women with stage IV IBC may benefit from aggressive combined modality management.
本回顾性研究旨在确定影响炎性乳腺癌（IBC）患者生存的因素。
在监测、流行病学和最终结果（SEER）注册中心检索 2004 年至 2007 年间诊断为 III/IV 期 IBC 的女性。IBC 由 SEER 作为 T4d 疾病识别，由美国癌症联合委员会第六版定义。采用 Kaplan-Meier 乘积限法描述炎性乳腺癌特异性生存（IBCS）。Cox 模型用于评估各种患者和肿瘤特征与 IBCS 的多变量关系。
共确定了 2384 例 IIIB/C 和 IV 期 IBC 女性患者。IIIb、IIIC 和 IV 期疾病的 2 年 IBCS 分别为 81%、67%和 42%（P<0.0001）。在多变量模型中，IIIb 期患者和 IIIC 期患者的 IBC 死亡风险分别降低了 63%（HR 0.373，95%CI 0.296-0.470，P<0.001）和 31%（HR 0.691，95%CI 0.512-0.933，P=0.016），与 IV 期疾病的女性相比。与 IBC 死亡风险降低相关的其他因素包括低级别肿瘤、白种人/其他种族、接受手术、接受放疗和激素受体阳性疾病。在 IV 期疾病患者中，与未接受手术的患者相比，接受原发灶手术的患者的死亡风险降低了 51%（HR=0.489，95%CI 0.339-0.704，P<0.0001）。
尽管 IBC 是一种侵袭性局部晚期乳腺癌亚型，但它具有异质性，各种因素影响生存。此外，我们的结果表明，IV 期 IBC 的亚组女性可能受益于积极的综合治疗。
