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Disease-free and overall survival after pathologic complete disease remission of cytologically proven inflammatory breast carcinoma axillary lymph node metastases after primary systemic chemotherapy
Article first published online: 27 JAN 2006
Copyright © 2006 American Cancer Society
Volume 106, Issue 5, pages 1000–1006, 1 March 2006
How to Cite
Hennessy, B. T., Gonzalez-Angulo, A. M., Hortobagyi, G. N., Cristofanilli, M., Kau, S. W., Broglio, K., Fornage, B., Singletary, S. E., Sahin, A., Buzdar, A. U. and Valero, V. (2006), Disease-free and overall survival after pathologic complete disease remission of cytologically proven inflammatory breast carcinoma axillary lymph node metastases after primary systemic chemotherapy. Cancer, 106: 1000–1006. doi: 10.1002/cncr.21726
- Issue published online: 17 FEB 2006
- Article first published online: 27 JAN 2006
- Manuscript Accepted: 24 AUG 2005
- Manuscript Received: 3 AUG 2005
- breast carcinoma;
- primary tumor;
- pathologic complete response
Breast carcinoma axillary lymph node (ALN) pathologic complete response (pCR) after primary chemotherapy is associated with significantly higher recurrence-free survival (RFS) and overall survival (OS) rates. The purpose of the current study was to determine long-term outcome in patients achieving a pCR of cytologically proven inflammatory breast carcinoma ALN metastases after primary chemotherapy.
Patients with cytologically documented ALN metastases from inflammatory breast carcinoma were treated in three prospective primary chemotherapy trials. After surgery, patients were subdivided into those patients with and those patients without residual ALN carcinoma. Survival was calculated using the Kaplan–Meier method.
Of 175 patients treated, 61 had cytologically confirmed ALN metastases. Fourteen patients (23%) achieved a pCR of the ALNs after primary chemotherapy. The 5-year OS and RFS rates were found to be improved in those patients achieving a pCR of the ALNs (82.5% [95% confidence interval (95% CI), 62.8–100%] and 78.6% [95%CI, 59.8–100%], respectively, vs. 37.1% [95%CI, 25.4–54.2%] and 25.4% [95%CI, 15.5–41.5%], respectively) (P = 0.01 [for OS] and P = 0.001 [for RFS]). Combination anthracycline and taxane-based primary chemotherapy resulted in significantly more patients achieving an ALN pCR (45% vs. 16%; P = 0.01).
pCR of ALN metastases is associated with an excellent prognosis in patients with inflammatory breast carcinoma. The rates of ALN pCR are nearly 50% in patients with inflammatory breast carcinoma who are treated with anthracyclines and weekly paclitaxel before surgery. However, those patients with residual ALN disease at the time of surgery greatly require the introduction of novel therapeutic strategies. Cancer 2006. © 2006 American Cancer Society.