Short- and long-term cause-specific survival of patients with inflammatory breast cancer.
BACKGROUND
Inflammatory breast cancer (IBC) had been perceived to have a poor prognosis. Oncologists were not enthusiastic in the past to give aggressive treatment. Single institution studies tend to have small patient numbers and limited years of follow-up. Most studies do not report 10-, 15- or 20-year results.


METHODS
Data was obtained from the population-based database of the Surveillance, Epidemiology, and End Results program of the National Cancer Institute from 1975-1995 using SEER*Stat5.0 software. This period of 21 years was divided into 7 periods of 3 years each. The years were chosen so that there was adequate follow-up information to 2000. ICD-O-2 histology 8530/3 was used to define IBC. The lognormal model was used for statistical analysis.


RESULTS
A total of 1684 patients were analyzed, of which 84% were white, 11% were African Americans, and 5% belonged to other races. Age distribution was < 30 years in 1%, 30-40 in 11%, 40-50 in 22%, 50-60 in 24%, 60-70 in 21%, and > 70 in 21%. The lognormal model was validated for 1975-77 and for 1978-80, since the 10-, 15- and 20-year cause-specific survival (CSS) rates, could be calculated using the Kaplan-Meier method with data available in 2000. The data were then used to estimate the 10-, 15- and 20-year CSS rates for the more recent years, and to study the trend of improvement in survival. There were increasing incidences of IBC: 134 patients in the 1975-77 period to 416 patients in the 1993-95 period. The corresponding 20-year CSS increased from 9% to 20% respectively with standard errors of less than 4%.


CONCLUSIONS
The improvement of survival during the study period may be due to introduction of more aggressive treatments. However, there seem to be no further increase of long-term CSS, which should encourage oncologists to find even more effective treatments. Because of small numbers of patients, randomized studies will be difficult to conduct. The SEER population-based database will yield the best possible estimate of the trend in improvement of survival for patients with IBC.
Tai
Patricia
P
University of Saskatchewan, Faculty of Medicine, Saskatoon, Canada. patricia.tai@scf.sk.ca
Yu
Edward
E
Shiels
Ross
R
Pacella
Juan
J
Jones
Kurian
K
Sadikov
Evgeny
E
Mahmood
Shazia
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000401:mortality*; D005260:Female; D006801:Humans; D007249:Inflammation; D008875:Middle Aged; D015233:Models, Statistical; D009316:National Institutes of Health (U.S.); D012042:Registries / Q000706:statistics & numerical data; D018426:SEER Program; D012984:Software; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States