Inflammatory breast cancer appearance at presentation is associated with overall survival

Abstract

Background Inflammatory breast cancer (IBC) is a clinical diagnosis. Here, we examined the association of a “classic” triad of clinical signs, swollen involved breast, nipple change, and diffuse skin change, with overall survival (OS). Method Breast medical photographs from patients enrolled on a prospective IBC registry were scored by two independent reviewers as classic (triad above), not classic, and difficult to assign. Chi‐squared test, Fisher's exact test, and Wilcoxon rank‐sum test were used to assess differences between patient groups. Kaplan–Meier estimates and the log‐rank test and Cox proportional hazard regression were used to assess the OS. Results We analyzed 245 IBC patients with median age 54 (range 26–81), M0 versus M1 status (157 and 88 patients, respectively). The classic triad was significantly associated with smoking, post‐menopausal status, and metastatic disease at presentation ( p = 0.002, 0.013, and 0.035, respectively). Ten‐year actuarial OS for not classic and difficult to assign were not significantly different and were grouped for further analyses. Ten‐year OS was 29.7% among patients with the classic sign triad versus 57.2% for non‐classic ( p < 0.0001). The multivariate Cox regression model adjusting for clinical staging ( p < 0.0001) and TNBC status (<0.0001) demonstrated classic presentation score significantly associated with poorer OS time (HR 2.6, 95% CI 1.7–3.9, p < 0.0001). Conclusions A triad of classic IBC signs independently predicted OS in patients diagnosed with IBC. Further work is warranted to understand the biology related to clinical signs and further extend the understanding of physical examination findings in IBC.

Current Challenges and Future Directions in the Management of Inflammatory Breast Cancer: A Review

“…[29] In addition, despite IBC having a unique clinical presentation that distinguishes it from non-IBC forms, the precise molecular mechanisms underpinning the disease remain elusive. [30] Treatments that have proven successful in non-IBC, such as targeted therapies for HER2 positive and hormonal receptor positive non-IBC, have resulted in improved patient outcomes. [25,31] However, applying these treatment strategies to IBC poses a considerable challenge, attributable to the unique biology of the disease.…”

High-fat diet, but not duration of lactation, increases mammary gland lymphatic vessel function and subsequent growth of inflammatory breast cancer cells

“…Inflammatory breast cancer (IBC) is an aggressive form of breast cancer that presents as rapid breast swelling and skin color changes thought to be due to congested lymphatics in the breast and breast skin [ 1 , 2 ]. These symptoms are partly attributed to IBC tumor emboli clogging dermal lymphatics around the breast, causing lymphovascular skin invasion (LVSI) [ 3 , 4 ].…”

A Novel Preclinical Murine Model to Monitor Inflammatory Breast Cancer Tumor Growth and Lymphovascular Invasion

“…Disproportionate rates of incidence and poor outcomes are also associated with self-identified African American women [ 13 , 14 ], recently linked to differential adaptive stress response gene expression [ 15 ]. Unlike other types of locally advanced breast cancers, the majority of IBC patients do not present with a solid tumor mass at diagnosis, nor is there any radiographic evidence of the presence of malignancy in the breast [ 16 ]. Instead, the clinicopathological hallmark of IBC is lymphovascular invasion (LVI) with the presence of tumor-cell clusters, termed tumor emboli, in the lymphovascular spaces [ 17 , 18 , 19 , 20 ].…”