title: Differences in survival among women with stage III inflammatory and noninflammatory locally advanced breast cancer appear early: a large population-based study.
abstract: BACKGROUND
  Significant improvements in the survival of women with breast cancer have been observed and are attributed to a multidisciplinary approach and the introduction of polychemotherapy and endocrine regimens. The objective of this population-based study was to determine whether women with inflammatory breast cancer (IBC) who received treatment in a modern era had a poorer survival compared those with non-IBC locally advanced breast cancer (LABC).
  
  
  METHODS
  The Surveillance, Epidemiology, and End Results program registry was searched to identify women with stage IIIB/C breast cancer diagnosed between 2004 and 2007 who had undergone surgery and radiotherapy. Patients were categorized as either having IBC or non-IBC LABC according the sixth edition of the American Joint Committee on Cancer (AJCC) criteria. Breast cancer-specific survival (BCS) was estimated using the Kaplan-Meier product limit method and compared across groups using the log-rank statistic. Cox models were then fitted to compare the association between breast cancer type and BCS after adjusting for patient and tumor characteristics.
  
  
  RESULTS
  A total of 828 (19.2%) women and 3476 (80.8%) women had stage IIIB/C IBC and non-IBC LABC, respectively. The median follow-up was 19 months. The 2-year BCS rate was 90% (95% confidence interval [95% CI], 88%-91%) for the entire cohort and 84% (95%CI, 80%-87%) and 91% (95%CI, 90%-91%) among women with IBC and non-IBC LABC, respectively. In the multivariable model, patients with IBC were found to have a 43% increased risk of death from breast cancer compared with patients with non-IBC LABC (hazard ratio, 1.43; 95%CI, 1.10-1.86 [P = .008]).
  
  
  CONCLUSIONS
  In the era of multidisciplinary management and anthracycline-based and taxane-based polychemotherapy regimens, women with IBC continue to have worse survival outcomes compared with those with non-IBC LABC.
authors.affiliation: Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. Shaheenah_d@yahoo.com
authors.forename: Shaheenah
authors.initials: S
authors.lastname: Dawood
authors.forename: Naoto T
authors.initials: NT
authors.lastname: Ueno
authors.forename: Vicente
authors.initials: V
authors.lastname: Valero
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Woodward
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Buchholz
authors.forename: Gabriel N
authors.initials: GN
authors.lastname: Hortobagyi
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Gonzalez-Angulo
authors.forename: Massimo
authors.initials: M
authors.lastname: Cristofanilli
mesh_terms: D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000401:mortality* / Q000473:pathology; D008875:Middle Aged; D011159:Population Surveillance; D011379:Prognosis; D018426:SEER Program; D015996:Survival Rate