title: Triple-negative subtype predicts poor overall survival and high locoregional relapse in inflammatory breast cancer.
abstract: BACKGROUND
  Numerous studies have demonstrated that expression of estrogen/progesterone receptor (ER/PR) and human epidermal growth factor receptor (HER)-2 is important for predicting overall survival (OS), distant relapse (DR), and locoregional relapse (LRR) in early and advanced breast cancer patients. However, these findings have not been confirmed for inflammatory breast cancer (IBC), which has different biological features than non-IBC.
  
  
  METHODS
  We retrospectively analyzed the records of 316 women who presented to MD Anderson Cancer Center in 1989-2008 with newly diagnosed IBC without distant metastases. Most patients received neoadjuvant chemotherapy, mastectomy, and postmastectomy radiation. Patients were grouped according to receptor status: ER(+) (ER(+)/PR(+) and HER-2-; n = 105), ER(+)HER-2(+) (ER(+)/PR(+) and HER-2(+); n = 37), HER-2(+) (ER(-)/PR(-) and HER-2(+); n = 83), or triple-negative (TN) (ER(-)PR(-)HER-2(-); n = 91). Kaplan-Meier and Cox proportional hazards methods were used to assess LRR, DR, and OS rates and their associations with prognostic factors.
  
  
  RESULTS
  The median age was 50 years (range, 24-83 years). The median follow-up time and median OS time for all patients were both 33 months. The 5-year actuarial OS rates were 58.7% for the entire cohort, 69.7% for ER(+) patients, 73.5% for ER(+)HER-2(+) patients, 54.0% for HER=2(+) patients, and 42.7% for TN patients (p < .0001); 5-year LRR rates were 20.3%, 8.0%, 12.6%, 22.6%, and 38.6%, respectively, for the four subgroups (p < .0001); and 5-year DR rates were 45.5%, 28.8%, 50.1%, 52.1%, and 56.7%, respectively (p < .001). OS and LRR rates were worse for TN patients than for any other subgroup (p < .0001-.03).
  
  
  CONCLUSIONS
  TN disease is associated with worse OS, DR, and LRR outcomes in IBC patients, indicating the need for developing new locoregional and systemic treatment strategies for patients with this aggressive subtype.
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Ana M
authors.initials: AM
authors.lastname: Gonzalez-Angulo
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Allen
authors.forename: Tse K
authors.initials: TK
authors.lastname: Yu
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Woodward
authors.forename: Naoto T
authors.initials: NT
authors.lastname: Ueno
authors.forename: Anthony
authors.initials: A
authors.lastname: Lucci
authors.forename: Savitri
authors.initials: S
authors.lastname: Krishnamurthy
authors.forename: Yun
authors.initials: Y
authors.lastname: Gong
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Bondy
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.forename: Jie S
authors.initials: JS
authors.lastname: Willey
authors.forename: Massimo
authors.initials: M
authors.lastname: Cristofanilli
authors.forename: Vicente
authors.initials: V
authors.lastname: Valero
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Buchholz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D058922:Inflammatory Breast Neoplasms / Q000737:chemistry / Q000175:diagnosis / Q000235:genetics / Q000401:mortality; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000737:chemistry*; D011379:Prognosis; D011960:Receptors, Estrogen / Q000032:analysis*; D011980:Receptors, Progesterone / Q000032:analysis*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D066246:ErbB Receptors