Monneur Audrey, Goncalves Anthony, Gilabert Marine, Finetti Pascal, Tarpin Carole, Zemmour Christophe, Extra Jean-Marc, Tallet Agnès, Lambaudie Eric, Jacquemier Jocelyne, Houvenaeghel Gilles, Boher Jean-Marie, Viens Patrice, Bertucci François
Département d'Oncologie Médicale, Centre de Recherche en Cancérologie de Marseille (CRCM), Institut Paoli-Calmettes, Marseille, France.
Faculté de Médecine, Aix-Marseille Université, Marseille, France.
Oncotarget. 2017 Jul 31;8(39):66019-66032. doi: 10.18632/oncotarget.19732. eCollection 2017 Sep 12.
Inflammatory breast cancer (IBC) is a very aggressive form of breast cancer, as compared to locally advanced breast cancer (LABC). Neoadjuvant chemotherapy followed by surgery is the standard treatment in both cases. Whether IBC is less chemosensitive than LABC remains unclear. We retrospectively compared the rate of pathological complete response (pCR) to neoadjuvant chemotherapy in IBC and LABC.
Patients with IBC or LABC treated with neoadjuvant anthracycline-based chemotherapy followed by surgery were selected from our institutional database. The primary endpoint was the pCR rate, defined as absence of invasive tumor in breast and axillary lymph nodes.
A total of 450 patients were included, 144 with IBC and 306 with LABC. The pCR rate was similar between the two groups, in the whole population (31%) and in each molecular subtype separately. Univariate analyses for pCR in IBC and LABC separately identified the same predictive variables, except the pathological type that was associated with pCR in LABC only, but not in IBC. IBC patients displayed shorter 5-year metastasis-free survival and overall survival than LABC patients in the whole population (57% and 69% and 88% respectively), and in each molecular subtype separately. The IBC phenotype was an independent prognostic feature. Similarly, IBC patients displayed shorter 5-year loco-regional relapse-free survival than LABC patients (86% 95%).
Similar pCR rates to chemotherapy were found in IBC and LABC, suggesting that IBC is not less chemosensitive than LABC. Survival was shorter in IBC, suggesting that the corresponding poorer prognosis is more due to a higher metastatic risk and/or other feature(s) than to a lesser chemosensitivity.
与局部晚期乳腺癌（LABC）相比，炎性乳腺癌（IBC）是一种侵袭性很强的乳腺癌形式。新辅助化疗后手术是这两种情况下的标准治疗方法。IBC是否比LABC对化疗更不敏感仍不清楚。我们回顾性比较了IBC和LABC中新辅助化疗的病理完全缓解（pCR）率。
从我们的机构数据库中选择接受新辅助蒽环类化疗后手术的IBC或LABC患者。主要终点是pCR率，定义为乳腺和腋窝淋巴结无浸润性肿瘤。
共纳入450例患者，144例为IBC，306例为LABC。两组之间的pCR率相似，在整个群体中（31%）以及在每种分子亚型中分别相似。分别对IBC和LABC中的pCR进行单变量分析，除了病理类型仅与LABC中的pCR相关，而与IBC中的pCR无关外，确定了相同的预测变量。在整个群体中以及在每种分子亚型中分别比较，IBC患者的5年无转移生存率和总生存率均低于LABC患者（分别为57%和69%以及88%）。IBC表型是一个独立的预后特征。同样，IBC患者的5年局部区域无复发生存期比LABC患者短（86%对95%）。
IBC和LABC中化疗的pCR率相似，表明IBC对化疗的敏感性并不低于LABC。IBC患者的生存期较短，表明相应较差的预后更多是由于转移风险较高和/或其他特征，而不是化疗敏感性较低。
