title: Management of inflammatory breast cancer after neoadjuvant chemotherapy.
abstract: OBJECTIVE
  To assess the benefit of breast surgery for inflammatory breast cancer (IBC).
  
  
  METHODS
  This retrospective series was based on 232 patients treated for IBC. All patients received primary chemotherapy followed by either exclusive radiotherapy (118 patients; 51%) or surgery with or without radiotherapy (114 patients; 49%). The median follow-up was 11 years.
  
  
  RESULTS
  The two groups were comparable apart from fewer tumors <70 mm (43% vs. 33%, p = 0.003), a higher rate of clinical stage N2 (15% vs. 5%, p = 0.04), and fewer histopathologic Grade 3 tumors (46% vs. 61%, p <0.05) in the no-surgery group. The addition of surgery was associated with a significant improvement in locoregional disease control (p = 0.04) at 10 years locoregional free interval 78% vs. 59% but with no significant difference in overall survival rates or disease-free intervals. Late toxicities were not significantly different between the two treatment groups except for a higher rate of fibrosis in the no-surgery group (p <0.0001) and more lymphedema in the surgery group (p = 0.002).
  
  
  CONCLUSIONS
  Our data suggest an improvement in locoregional control in patients treated by surgery, in conjunction with chemotherapy and radiotherapy, for IBC. Efforts must be made to improve overall survival.
authors.affiliation: Department of Radiation Oncology, Institut Curie, Paris, France.
authors.forename: Soumya
authors.initials: S
authors.lastname: Abrous-Anane
authors.forename: Alexia
authors.initials: A
authors.lastname: Savignoni
authors.forename: Caroline
authors.initials: C
authors.lastname: Daveau
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Pierga
authors.forename: Chantal
authors.initials: C
authors.lastname: Gautier
authors.forename: Fabien
authors.initials: F
authors.lastname: Reyal
authors.forename: Remi
authors.initials: R
authors.lastname: Dendale
authors.forename: François
authors.initials: F
authors.lastname: Campana
authors.forename: Youlia M
authors.initials: YM
authors.lastname: Kirova
authors.forename: Alain
authors.initials: A
authors.lastname: Fourquet
authors.forename: Marc A
authors.initials: MA
authors.lastname: Bollet
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D014751:Vindesine / Q000008:administration & dosage; D000077235:Vinorelbine
chemical_list: D014747:Vinblastine; D003520:Cyclophosphamide; D000077235:Vinorelbine; D014751:Vindesine; D005472:Fluorouracil