Combined therapy for inflammatory breast cancer.

The prognosis for patients with inflammatory breast cancer has improved in recent years. This review was undertaken to evaluate current management in three Milwaukee (Wis) hospitals and to identify determinants of prognosis. We identified 25 patients with inflammatory breast carcinoma diagnosed between 1967 and 1987. Most of the patients were treated with combination chemotherapy and radiation therapy, and 10 had mastectomies. The 5-year survival of patients without initial distant metastases was 24%. The 5-year survival of patients who received chemotherapy before local treatment was 40%. Patients who had clinically involved axillary nodes or a palpable mass in the breast had poorer survival than those who did not; the presence of dermal lymphatic invasion had no significant effect on survival. Initial chemotherapy has become an important part of the care of patients with inflammatory breast cancer. It remains uncertain whether mastectomy improves on irradiation in achieving local control or improves survival.