Muzaffar Mahvish, Johnson Helen M, Vohra Nasreen A, Liles Darla, Wong Jan H
Department of Medicine, Division of Hematology/Oncology, East Carolina University Brody School of Medicine, Greenville, NC, USA.
Department of Surgery, Division of Surgical Oncology, East Carolina University Brody School of Medicine, Greenville, NC, USA.
Int J Breast Cancer. 2018 Jun 3;2018:6438635. doi: 10.1155/2018/6438635. eCollection 2018.
Inflammatory breast cancer (IBC) is a rare but most aggressive breast cancer subtype. The impact of locoregional therapy on survival in IBC is controversial.
Patients with nonmetastatic IBC between 1988 and 2013 were identified in the Surveillance, Epidemiology, and End Results (SEER) registry.
We identified 7,304 female patients with nonmetastatic inflammatory breast cancer (IBC) who underwent primary tumor surgery. Most patients underwent total mastectomy with only 409 (5.6%) undergoing a partial mastectomy. In addition, 4,559 (62.4%) were also treated with radiation therapy. The patients who underwent mastectomy had better survival compared to partial mastectomy (49% versus 43%, = 0.003). The addition of radiation therapy was also associated with improved 5-year survival (55% versus 40%, < 0.001). Multivariate analysis showed that black race HR (1.22, 95% CI 1.18-1.35), ER negative status (HR 1.22, 95% CI 1.16-1.28), and higher grade (HR 1.14, 95% CI 1.07-1.20) were associated with poor outcome. Cox proportional hazards model showed that total mastectomy (HR 0.75, 95% CI 0.65-0.85) and radiation (HR 0.64, 95% CI 0.61-0.69) were associated with improved survival.
Optimal locoregional therapy for women with nonmetastatic IBC continues to be mastectomy and radiation therapy. These data reinforce the prevailing treatment algorithm for nonmetastatic IBC.
炎性乳腺癌（IBC）是一种罕见但侵袭性最强的乳腺癌亚型。局部区域治疗对IBC患者生存的影响存在争议。
在监测、流行病学和最终结果（SEER）登记处识别出1988年至2013年间患有非转移性IBC的患者。
我们识别出7304例接受原发性肿瘤手术的非转移性炎性乳腺癌（IBC）女性患者。大多数患者接受了全乳切除术，只有409例（5.6%）接受了部分乳房切除术。此外，4559例（62.4%）还接受了放射治疗。与部分乳房切除术相比，接受全乳切除术的患者生存率更高（49%对43%，P = 0.003）。放射治疗的加入也与5年生存率的提高相关（55%对40%，P < 0.001）。多变量分析显示，黑人种族HR（1.22，95%CI 1.18 - 1.35）、雌激素受体阴性状态（HR 1.22，95%CI 1.16 - 1.28）和更高分级（HR 1.14，95%CI 1.07 - 1.20）与不良预后相关。Cox比例风险模型显示，全乳切除术（HR 0.75，95%CI 0.65 - 0.85）和放射治疗（HR 0.64，95%CI 0.61 - 0.69）与生存率提高相关。
非转移性IBC女性的最佳局部区域治疗仍然是乳房切除术和放射治疗。这些数据强化了非转移性IBC现行的治疗方案。
