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英国炎性乳腺癌病例的表现、治疗和结局:多中心回顾性研究数据。

The presentation, management and outcome of inflammatory breast cancer cases in the UK: Data from a multi-centre retrospective review.

机构信息

Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK.

Department of Histopathology and University of Birmingham, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B152GW, UK.

出版信息

Breast. 2018 Dec;42:133-141. doi: 10.1016/j.breast.2018.09.003. Epub 2018 Sep 15.

Abstract

OBJECTIVES

Inflammatory Breast cancer (IBC) is a rare but aggressive form of breast cancer. Its incidence and behaviour in the UK is poorly characterised. We collected retrospective data from hospitals in the UK and Ireland to describe the presentation, pathology, treatment and clinical course of IBC in the UK.

MATERIALS AND METHODS

Patients with IBC diagnosed between 1997-2014 at fourteen UK and Irish hospitals were identified from local breast unit databases. Patient characteristics, tumour pathology and stage, and details of surgical, systemic and radiotherapy treatment and follow-up data were collected from electronic patient records and medical notes.

RESULT

This retrospective review identified 445 patients with IBC accounting for 0.4-1.8% of invasive breast cancer cases. Median follow-up was 4.2 years. 53.2% of tumours were grade 3, 56.2% were oestrogen receptor positive, 31.3% were HER2 positive and 25.1% were triple negative. 20.7% of patients had distant metastases at presentation. Despite trimodality treatment in 86.4%, 40.1% of stage III patients developed distant metastases. Five-year overall survival (OS) was 61.0% for stage III and 21.4% for stage IV patients.

CONCLUSIONS

This is the largest series of UK IBC patients reported to date. It indicates a lower incidence than in American series, but confirms that IBC has a high risk of recurrence with poor survival despite contemporary multi-modality therapy. A national strategy is required to facilitate translational research into this aggressive disease.

摘要

目的

炎性乳腺癌(IBC)是一种罕见但侵袭性很强的乳腺癌。其在英国的发病率和表现形式尚未得到充分描述。我们从英国和爱尔兰的医院收集了回顾性数据,以描述英国 IBC 的表现、病理学、治疗和临床过程。

材料和方法

从 14 家英国和爱尔兰医院的当地乳腺单位数据库中确定了 1997-2014 年间诊断为 IBC 的患者。从电子患者记录和病历中收集了患者特征、肿瘤病理学和分期以及手术、全身和放疗治疗以及随访数据的详细信息。

结果

这项回顾性研究确定了 445 例 IBC 患者,占浸润性乳腺癌病例的 0.4-1.8%。中位随访时间为 4.2 年。53.2%的肿瘤分级为 3 级,56.2%的肿瘤雌激素受体阳性,31.3%的肿瘤 HER2 阳性,25.1%的肿瘤三阴性。20.7%的患者在就诊时已有远处转移。尽管 86.4%的患者接受了三联疗法,但仍有 40.1%的 III 期患者发生远处转移。III 期患者的 5 年总生存率(OS)为 61.0%,IV 期患者为 21.4%。

结论

这是迄今为止报道的最大系列英国 IBC 患者。它表明发病率低于美国系列,但证实 IBC 尽管采用了当代多模式治疗,但复发风险高,生存预后差。需要制定国家战略,以促进对这种侵袭性疾病的转化研究。

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