Zhou Qi, Zhang Hai-Ping, Zhao Ya-Ting, Wang Xiao-Hong, Xiong Wei, Liu Yun-Jiang, Zhang Jing-Hua
Department of Breast Surgery, Tangshan People's Hospital, Tangshan, Hebei 063001, China.
Department of Breast Center, Tangshan People's Hospital, Tangshan, Hebei 063001, China.
Chin Med J (Engl). 2020 Nov 5;133(21):2552-2557. doi: 10.1097/CM9.0000000000001104.
Inflammatory breast cancer (IBC) is an aggressive type of cancer with poor prognosis and outcomes. This study aimed to investigate clinicopathological features, molecular characteristics, and treatments among Chinese patients diagnosed with IBC.
We collected data of 95 patients with IBC who were treated by members of the Chinese Society of Breast Surgery, from January 2017 to December 2018. The data, including demographic characteristics, pathological findings, surgical methods, systemic treatment plans, and follow-up, were obtained using a uniform electronic questionnaire. The clinicopathological features of different molecular types in patients without distant metastases were compared using the Kruskal-Wallis (H) test followed by post hoc analyses.
Lymph node metastasis was noted in 75.8% of all patients, while distant metastasis was noted in 21.4%. Pathological findings indicated invasive ductal and lobular carcinomas in 86.8% and 5.3% of cases, respectively. Hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) (41.5%) and HR-/HER2+ (20.1%) were the most common biologic subtypes, followed by HR+/HER2+ (19.1%) and HR-/HER2- (19.1%). Stage III IBC was treated via pre-operative neoadjuvant chemotherapy in 87.7% of the cases, predominantly using anthracycline and taxanes. A total of 91.9% of patients underwent surgical treatment. Among them, 77.0% of the patients underwent modified radical mastectomy, 8.1% of whom also underwent immediate breast reconstruction. The Kruskal-Wallis test revealed that the efficacy of chemotherapy significantly differed among those with HR+/HER2- and HR-/HER2- tumors (adjusted P = 0.008), and Ki-67 expression significantly differed in HR-/HER2+ and HR+/HER2+ molecular subtypes (adjusted P = 0.008).
Our study provides novel insight into clinicopathological characteristics and treatment status among patients with IBC in China, and might provide a direction and basis for further studies.
chictr.org.cn, No. ChiCTR1900027179; http://www.chictr.org.cn/showprojen.aspx?proj=45030.
炎性乳腺癌（IBC）是一种侵袭性癌症，预后和结局较差。本研究旨在调查中国IBC确诊患者的临床病理特征、分子特征及治疗情况。
我们收集了2017年1月至2018年12月间由中国乳腺外科学会成员治疗的95例IBC患者的数据。数据包括人口统计学特征、病理检查结果、手术方式、全身治疗方案及随访情况，通过统一的电子问卷获取。对无远处转移患者不同分子类型的临床病理特征进行比较，采用Kruskal-Wallis（H）检验及事后分析。
所有患者中75.8%有淋巴结转移，21.4%有远处转移。病理检查结果显示，86.8%的病例为浸润性导管癌，5.3%为浸润性小叶癌。激素受体阳性（HR+）/人表皮生长因子受体2阴性（HER2-）（41.5%）和HR-/HER2+（20.1%）是最常见的生物学亚型，其次是HR+/HER2+（19.1%）和HR-/HER2-（19.1%）。87.7%的III期IBC患者接受术前新辅助化疗，主要使用蒽环类药物和紫杉烷类药物。共有91.9%的患者接受了手术治疗。其中，77.0%的患者接受了改良根治性乳房切除术,8.1%的患者同时接受了即刻乳房重建。Kruskal-Wallis检验显示，HR+/HER2-和HR-/HER2-肿瘤患者化疗疗效差异显著（校正P = 0.008），HR-/HER2+和HR+/HER2+分子亚型的Ki-67表达差异显著（校正P = 0.008）。
我们的研究为中国IBC患者的临床病理特征及治疗现状提供了新的见解，可能为进一步研究提供方向和依据。
chictr.org.cn，编号ChiCTR1900027179；http://www.chictr.org.cn/showprojen.aspx?proj=45030。
