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Differences in survival among women with stage III inflammatory and noninflammatory locally advanced breast cancer appear early
A large population-based study
Version of Record online: 29 NOV 2010
Copyright © 2010 American Cancer Society
Volume 117, Issue 9, pages 1819–1826, 1 May 2011
How to Cite
Dawood, S., Ueno, N. T., Valero, V., Woodward, W. A., Buchholz, T. A., Hortobagyi, G. N., Gonzalez-Angulo, A. M. and Cristofanilli, M. (2011), Differences in survival among women with stage III inflammatory and noninflammatory locally advanced breast cancer appear early. Cancer, 117: 1819–1826. doi: 10.1002/cncr.25682
- Issue online: 19 APR 2011
- Version of Record online: 29 NOV 2010
- Manuscript Revised: 9 SEP 2010
- Manuscript Accepted: 31 AUG 2010
- Manuscript Received: 12 JUN 2010
- inflammatory breast cancer;
- locally advanced breast cancer;
- multidisciplinary management;
Significant improvements in the survival of women with breast cancer have been observed and are attributed to a multidisciplinary approach and the introduction of polychemotherapy and endocrine regimens. The objective of this population-based study was to determine whether women with inflammatory breast cancer (IBC) who received treatment in a modern era had a poorer survival compared those with non-IBC locally advanced breast cancer (LABC).
The Surveillance, Epidemiology, and End Results program registry was searched to identify women with stage IIIB/C breast cancer diagnosed between 2004 and 2007 who had undergone surgery and radiotherapy. Patients were categorized as either having IBC or non-IBC LABC according the sixth edition of the American Joint Committee on Cancer (AJCC) criteria. Breast cancer-specific survival (BCS) was estimated using the Kaplan-Meier product limit method and compared across groups using the log-rank statistic. Cox models were then fitted to compare the association between breast cancer type and BCS after adjusting for patient and tumor characteristics.
A total of 828 (19.2%) women and 3476 (80.8%) women had stage IIIB/C IBC and non-IBC LABC, respectively. The median follow-up was 19 months. The 2-year BCS rate was 90% (95% confidence interval [95% CI], 88%-91%) for the entire cohort and 84% (95%CI, 80%-87%) and 91% (95%CI, 90%-91%) among women with IBC and non-IBC LABC, respectively. In the multivariable model, patients with IBC were found to have a 43% increased risk of death from breast cancer compared with patients with non-IBC LABC (hazard ratio, 1.43; 95%CI, 1.10-1.86 [P = .008]).
In the era of multidisciplinary management and anthracycline-based and taxane-based polychemotherapy regimens, women with IBC continue to have worse survival outcomes compared with those with non-IBC LABC. Cancer 2011. © 2010 American Cancer Society.