title: Overall survival differences between patients with inflammatory and noninflammatory breast cancer presenting with distant metastasis at diagnosis.
abstract: Inflammatory breast cancer (IBC) is a rare and aggressive disease. Previous studies have shown that among patients with stage III breast cancer, IBC is associated with a worse prognosis than noninflammatory breast cancer (non-IBC). Whether this difference holds true among patients with stage IV breast cancer has not been studied. We tested the hypothesis that overall survival (OS) is worse in patients with IBC than in those with non-IBC among patients with distant metastasis at diagnosis (stage IV disease). We reviewed the records of 1504 consecutive patients with stage IV breast cancer (IBC: 206; non-IBC: 1298) treated at our institution from 1987 through 2012. Survival curves for IBC and non-IBC subcohorts were compared. The Cox proportional hazards model was used to determine predictors of OS. The median follow-up period was 4.7 years. IBC was associated with shorter median OS time than non-IBC (2.27 vs. 3.40 years; P = 0.0128, log-rank test). In a multicovariate Cox model that included 1389 patients, the diagnosis of IBC was a significant independent predictor of worse OS (hazard ratio = 1.431, P = 0.0011). Other significant predictors of worse OS included Black (vs. White) ethnicity, younger age at diagnosis, negative HER2 status, and visceral (vs. nonvisceral) site of metastasis. IBC is associated with shorter OS than non-IBC in patients with distant metastasis at diagnosis. The prognostic impact of IBC should be taken into consideration among patients with stage IV breast cancer.
authors.affiliation: Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Tamer M
authors.initials: TM
authors.lastname: Fouad
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kogawa
authors.forename: Diane D
authors.initials: DD
authors.lastname: Liu
authors.forename: Yu
authors.initials: Y
authors.lastname: Shen
authors.forename: Hiroko
authors.initials: H
authors.lastname: Masuda
authors.forename: Randa
authors.initials: R
authors.lastname: El-Zein
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Woodward
authors.forename: Mariana
authors.initials: M
authors.lastname: Chavez-MacGregor
authors.forename: Ricardo H
authors.initials: RH
authors.lastname: Alvarez
authors.forename: Banu
authors.initials: B
authors.lastname: Arun
authors.forename: Anthony
authors.initials: A
authors.lastname: Lucci
authors.forename: Savitri
authors.initials: S
authors.lastname: Krishnamurthy
authors.forename: Gildy
authors.initials: G
authors.lastname: Babiera
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Buchholz
authors.forename: Vicente
authors.initials: V
authors.lastname: Valero
authors.forename: Naoto T
authors.initials: NT
authors.lastname: Ueno
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor