Immediate Reconstruction in Inflammatory Breast Cancer: Challenging Current Care

Simpson, Ashley; McCray, Devina K. S.; Wengler, Craig; Crowe, Joseph P.; Djohan, Risal; Tendulkar, Rahul D.; O’Rourke, Colin; Grobmyer, Stephen R.; Valente, Stephanie A.

doi:10.1245/s10434-016-5554-z

Cited by 20 publications

(32 citation statements)

References 28 publications

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“…Simpson et al reported their institutional experience with breast reconstruction in 60 patients with stage III IBC. Sixteen (27%) underwent immediate reconstruction: 81%—tissue expander placement and 19%—autologous tissue.…”

Section: Discussionmentioning

confidence: 99%

“…Simpson et al also found that immediate reconstruction was not associated with a delay in initiating RT. The patients who underwent immediate reconstruction began RT after a median of 52.5 days post‐MRM, which was not statistically significant from the time of initiating RT among those with delayed reconstruction or no reconstruction (45 days and 42 days, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…gram which was prompted by disease relapse. Further investigation is needed to estimate the incidence of adverse oncologic outcomes in this patient population.Simpson et al14 reported their institutional experience with breast reconstruction in 60 patients with stage III IBC. Sixteen (27%) underwent immediate reconstruction: 81%-tissue expander placement and 19%-autologous tissue.…”

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confidence: 99%

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Patterns of breast reconstruction in patients diagnosed with inflammatory breast cancer: The Dana‐Farber Cancer Institute's Inflammatory Breast Cancer Program experience

et al. 2020

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Inflammatory breast cancer (IBC) exhibits dermal lymphatic involvement at presentation, and thus, the standard surgical approach is a nonskin‐sparing modified radical mastectomy (MRM) without breast reconstruction (BR). In this study, we evaluated immediate and delayed BR receipt and its outcomes in IBC. Using an IRB‐approved database, we retrospectively evaluated stage III IBC patients who received trimodality therapy (preoperative systemic therapy, followed by MRM and postmastectomy chest wall/regional nodal radiation). Patients with an insufficient response to preoperative systemic therapy and/or who required preoperative radiotherapy were excluded. BR receipt, timing, and morbidity were evaluated. Among 240 stage III IBC patients diagnosed between 1997 and 2016, 40 (17%) underwent BR. Thirteen (33%) had immediate, and 27 (67%) had delayed BR. Four patients had complications (1 [8%] immediate BR and 3 [11%] delayed BR); only 1 BR (delayed) was unsuccessful. From the MRM date, the median time to recurrence was 35 months (<1‐212) and median overall survival was 87 months (<1‐212). In this cohort of stage III IBC patients, only 11% pursued delayed BR following trimodality therapy, possibly attributable to the observed high recurrence rates hindering BR. Further studies addressing BR outcomes in IBC are needed for better counseling patients regarding their reconstructive options.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Patterns of breast reconstruction in patients diagnosed with inflammatory breast cancer: The Dana‐Farber Cancer Institute's Inflammatory Breast Cancer Program experience

et al. 2020

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“…A few single-institution studies and a SEER-Medicare database study have suggested that performing IBR for patients with IBC does not negatively impact survival [49,[54][55][56]. Chin et al compared 23 IBC patients who underwent mostly autologous reconstruction (14 in the IBR setting) to nonreconstructed historical controls and found no difference in disease-free or OS [54].…”

Section: Safety Of Immediate Breast Reconstructionmentioning

confidence: 99%

Locoregional Management of Inflammatory Breast Cancer

Baker

Hegde

Thompson

et al. 2020

Curr Breast Cancer Rep

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Purpose of Review Inflammatory breast cancer (IBC) is a biologically aggressive subtype with a high risk for rapid local progression and early distant metastasis. We review the updated data for optimal locoregional management of IBC, including areas of active controversy. Recent Findings Advancements in tri-modality therapies have improved survival among IBC patients in recent years; however, the risk of locoregional and distant recurrence remains high, particularly in triple-negative IBC. Data to support de-escalation of surgery or radiotherapy is limited, and the recommended treatment approach for non-metastatic IBC remains preoperative systemic therapy (PST), modified radical mastectomy (MRM), and adjuvant radiotherapy in all patients. For patients with de novo metastatic disease, locoregional intervention may be appropriate. Summary Optimal locoregional management of IBC remains PST followed by MRM and adjuvant radiotherapy. With increasingly effective systemic therapies, research to identify a subset of patients who may benefit from de-escalation of locoregional therapies is warranted.

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“…,16,17 Chin et al3 reported no difference in disease-free or overall survival when comparing 22 IBC patients to nonreconstructed historical controls. The median disease-free and overall survival rates were 19 and 22 months, respectively.…”

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Immediate breast reconstruction for women having inflammatory breast cancer in the United States

Patel

Nardello

et al. 2018

Cancer Medicine

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Inflammatory breast cancer (IBC) is an aggressive malignancy having a poor prognosis. Traditionally, reconstruction is not offered due to concerns about treatment delay, margin positivity, recurrence, and poor long‐term survival. There is a paucity of literature, however, evaluating whether immediate breast reconstruction (IBR) is associated with greater mortality in patients with IBC. A population‐based study was conducted via the SEER‐Medicare‐linked database (1991‐2009). Female patients greater than 65 years were reviewed who had mastectomy and reconstruction claims for nonmetastatic IBC. Competing risk and Cox regression were used to assess whether IBR was associated with higher breast cancer‐specific mortality (BCSM) or overall mortality (OM). Among 552 936 patients, 1472 (median age 74 years) were diagnosed with IBC and had a mastectomy. Forty‐four patients (3%) underwent IBR. Younger age, a lower Charlson comorbidity score, and a greater median income were predictors of IBR use. Tumor grade, hormone receptor status, and lymph node status were independent predictors of adjusted OM and BCSM. There was no difference by IBR status in BCSM or covariate‐adjusted BCSM (sHR 1.04; CI 0.71‐1.54; P = .83 and sHR 1.13; CI 0.84‐1.93; P = .58, respectively). Cumulative incidence of OM was lower among IR patients (P = .013), and IR did not influence the cumulative incidence of BCSM (P = .91). IBR was not associated with increased overall and BCSM mortality. Although further study of IBR in the IBC setting may be of value, these data suggest that IBC should not be considered an absolute contraindication to IBR.

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Immediate Reconstruction in Inflammatory Breast Cancer: Challenging Current Care

Abstract: Performing IR with mastectomy for IBC is associated with increased complications, but is not associated with decreased survival or increased recurrence in selected patients. IR in selected IBC patients can facilitate successful breast reconstruction.

Cited by 20 publications

References 28 publications

Patterns of breast reconstruction in patients diagnosed with inflammatory breast cancer: The Dana‐Farber Cancer Institute's Inflammatory Breast Cancer Program experience

Patterns of breast reconstruction in patients diagnosed with inflammatory breast cancer: The Dana‐Farber Cancer Institute's Inflammatory Breast Cancer Program experience

Locoregional Management of Inflammatory Breast Cancer

Immediate breast reconstruction for women having inflammatory breast cancer in the United States

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