A Single-Institution Experience with Inflammatory Breast Cancer

Comment regarding the paper: Smoot RL, Koch CA, Degnim AC, Sterioff S, Donohue JH, Grant CS, Barnes SA, Gullerud RE, Hobday TJ, Farley DR.  A single-center experience with inflammatory breast cancer, 1985-2003.  Arch Surg 2006 June; 141:567-73

Inflammatory breast cancer remains an especially difficult disease process to treat.  Previous investigations have examined multiple different treatment regimens including recent retrospective work examining the sequencing of trimodal therapy (chemotherapy, surgery, radiation).  This work suggested a possible survival benefit for patients undergoing surgery first. 

We examined our single institution experience over a 19-year period, with specific attention to the sequence of therapy.  One-hundred twenty-eight patients without metastatic disease had a median survival and disease-free time of 37 and 23 months respectively.  Twenty-two patients underwent surgery first, while 106 received chemotherapy first.  No difference was noted in survival based on sequence of therapy.  Multivariate analysis demonstrated increased time to recurrence in patients that were post-menopausal, increased survival in patients that received radiation therapy, and decreased survival in patients presenting with palpable adenopathy.  Inflammatory breast cancer continues to have a poor prognosis, and further investigations are needed to improve survival.

Bibliographic reference:

Liauw SL, Benda RK, Morris CG, Mendenhall NP. Inflammatory breast carcinoma: outcomes with trimodality therapy for nonmetastatic disease. Cancer. 2004;100(5):920-928.

David R. Farley

Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minn, USA