Equipe de recherche ONCOGYMA, Faculty of Medicine and Pharmacy of Rabat, University Mohamed V Rabat, Avenue Mohammed Belarbi El Alaoui - Souissi - BP, 6203, Rabat, Morocco.
Unité de Biologie et Recherche Médicale, Centre National de l'Energie, des Sciences et des Techniques Nucléaires, Rabat, Morocco.
BMC Cancer. 2018 Jul 5;18(1):713. doi: 10.1186/s12885-018-4634-9.
Usually misdiagnosed, Inflammatory Breast Cancer (IBC) is the most aggressive form of non-metastatic breast cancer. This orphan disease is more frequent in North Africa. Despite intensive treatment, the survival rate remains very low.
We have retrospectively studied all breast cancer cases diagnosed at the National Oncology Institute (INO), Rabat between 2005 and 2010. We have collected 219 cases of women with metastatic and non-metastatic IBC. Data have been obtained from patients' personal medical files over a follow-up period of 5 years. We have described IBC's clinicopathological features and analyzed its clinical outcome using SPSS software. HR (hazard Ratio) was calculated using Cox regression analysis.
The frequency of IBC cases is 4.05%. The majority of our patients (65.3%) were under 50 years old. The most prevalent molecular subtype was Luminal A (38.7%) followed by Luminal B HER2+ (27.9%) and Triple negative (21.6%). During the follow-up period, 72 patients (32.9%) had recurrence and 40 patients (18.3%) died. The 3-year OS (Overall Survival) and EFS (Event Free Survival) of non-metastatic patients were 70.4 and 46.5% respectively, while in the metastatic disease, the 3-year OS was only 41.9%. In non-metastatic women, we observed a higher rate of EFS associated to Selective estrogen receptor modulation treatment (p = 0.01), and a lower rate EFS in triple negative breast cancer patients (p = 0.02). In univariate analysis, we found that EFS rate is lower in patients presenting Triple Negative tumors when compared to other molecular subtypes (HR: 3.54; 95%CI: 1.13-11.05; p = 0.02). We also found that Selective estrogen receptor modulation treatment is associated with higher EFS rate (HR: 0.48; 95%CI: 0.07-0.59; p = 0.01).
IBC in Morocco shows similar characteristics to those in North African countries; however, survival rates are still the highest when compared with neighboring countries. Collaborative studies with prospective aspects are warranted to establish the epidemiological profile and understand the high frequencies of IBC in North Africa. More studies on molecular markers are also needed to improve IBC patients' management and eventually their survival rate.
炎性乳腺癌（IBC）通常被误诊，是最具侵袭性的非转移性乳腺癌形式。这种孤儿病在北非更为常见。尽管进行了强化治疗，但其生存率仍然非常低。
我们回顾性研究了 2005 年至 2010 年在摩洛哥国家肿瘤研究所（INO）诊断的所有乳腺癌病例。我们收集了 219 例转移性和非转移性 IBC 女性患者。数据来自患者的个人医疗档案，随访时间为 5 年。我们描述了 IBC 的临床病理特征，并使用 SPSS 软件分析了其临床结局。使用 Cox 回归分析计算 HR（风险比）。
IBC 病例的频率为 4.05%。我们的大多数患者（65.3%）年龄在 50 岁以下。最常见的分子亚型是 Luminal A（38.7%），其次是 Luminal B HER2+（27.9%）和三阴性（21.6%）。在随访期间，72 名患者（32.9%）出现复发，40 名患者（18.3%）死亡。非转移性患者的 3 年 OS（总体生存率）和 EFS（无事件生存率）分别为 70.4%和 46.5%，而转移性疾病的 3 年 OS 仅为 41.9%。在非转移性女性中，我们观察到选择性雌激素受体调节剂治疗与更高的 EFS 相关（p=0.01），而三阴性乳腺癌患者的 EFS 较低（p=0.02）。在单因素分析中，我们发现与其他分子亚型相比，三阴性肿瘤患者的 EFS 率较低（HR：3.54；95%CI：1.13-11.05；p=0.02）。我们还发现，选择性雌激素受体调节剂治疗与更高的 EFS 率相关（HR：0.48；95%CI：0.07-0.59；p=0.01）。
摩洛哥的 IBC 与北非国家具有相似的特征，但与邻国相比，生存率仍然最高。需要进行前瞻性的合作研究，以建立流行病学特征，并了解北非 IBC 高发的原因。还需要更多关于分子标志物的研究，以改善 IBC 患者的管理，最终提高其生存率。
