A comprehensive evaluation of outcomes for inflammatory breast cancer.
OBJECTIVE
Inflammatory breast cancer (IBC) remains the breast malignancy with the worst prognosis. We sought to determine the effects of race, socioeconomic status and treatment on outcomes for women with IBC. Study design The Florida cancer registry, inpatient and ambulatory data were queried for patients diagnosed from 1998 to 2002.


RESULTS
A total of 935 patients with IBC were identified (1.5% of all breast cancers). Overall, 83.1% were Caucasian, 13.9% African American (AA), and 15.7% Hispanic. The mean age of diagnosis was 57 years old. AA patients presented at a younger age, with higher tumor grade, and were less likely to undergo surgical therapy than their Caucasian counterparts. Median survival time (MST) for the entire cohort was 32 months, while MST for AA patients was 20 months. Patients who received chemotherapy before surgery, surgery without chemotherapy, and surgery before chemotherapy demonstrated an independent, significantly improved outcome in comparison to patients who underwent chemotherapy without surgical extirpation. The administration of radiation therapy did not demonstrate an improvement in survival. By multivariate analysis, AA race (HR = 2.19) and failure to provide surgery (HR = 2.3) were independent predictors of worse prognosis. No effect of poverty or ethnicity on outcome was observed.


CONCLUSIONS
IBC carries a poor prognosis for all patients with significantly worse outcomes for AA women. Multimodality therapy provided the best survival rates.
Yang
Relin
R
DeWitt Daughtry Family Department of Surgery, Division of Surgical Oncology, Sylvester Comprehensive Cancer Center, Alan Livingstone Chair in Surgical Oncology, University of Miami Miller School of Medicine, 3550 Sylvester Comprehensive Cancer Center, 1475 NW 12th Ave, Miami, FL 33136, USA.
Cheung
Michael C
MC
Hurley
Judith
J
Byrne
Margaret M
MM
Huang
Youjie
Y
Zimmers
Teresa A
TA
Koniaris
Leonidas G
LG
D000328:Adult; D001741:Black or African American; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D044469:Racial Groups; D011878:Radiotherapy; D012042:Registries; D012959:Socioeconomic Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D044465:White People
D000970:Antineoplastic Agents