title: Inflammatory TNBC Breast Cancer: Demography and Clinical Outcome in a Large Cohort of Patients With TNBC.
abstract: BACKGROUND
  Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer with poor 5-year survival. Knowledge and information about IBC with the triple negative (TNBC) phenotype are limited. Here, we report the characteristics and outcome of inflammatory TNBC (I-TNBC) cancer cohorts from a large TNBC dataset.
  
  
  METHODS
  After obtaining institutional review board approval, we collected information on 476 women with a diagnosis of TNBC from 1996 to 2011. Data on patient characteristics, tumor, and treatment were collected. Overall survival (OS) was computed from the date of diagnosis to the date of death or last follow-up. For disease-free survival (DFS), patients were scored if they failed. Statistical analysis was performed using SAS v9.3.
  
  
  RESULTS
  A total of 34 (7%) patients were diagnosed with inflammatory TNBC. The median age was 52 years, and 56% were white. The median follow-up was 13 months (interquartile range, 2-126 months). Twenty-one percent (n = 7) presented with stage IV disease, while 91% had axillary nodal involvement. All but 2 (94%; n = 32) patients had neoadjuvant chemotherapy, with 6% (n = 2) achieving complete response. Twenty-one (62%) patients underwent mastectomy; 71% (n = 24) received radiation. The 2- and 5-year OS and DFS were 34%, 26% (vs. 65%, 46%) and 27%, 23% (vs. 53%, 40%), respectively, for I-TNBC and non-inflammatory stage III-IV TNBC. Compared with the non-inflammatory group, the 2- and 5-year OS (P < .0005) and DFS (P < .0073) were significantly inferior for I-TNBC.
  
  
  CONCLUSIONS
  IBC with the triple negative phenotype is an aggressive disease with a significantly inferior outcome compared with non-inflammatory locally advanced TNBC. Newer strategies are required to improve survival outcome.
authors.affiliation: Department of Radiation Oncology, University Hospitals, Case Western Reserve University, Cleveland, OH. Electronic address: tithi.biswas@uhhospitals.org.
authors.forename: Tithi
authors.initials: T
authors.lastname: Biswas
authors.affiliation: Center for Health Disparities, Brody School of Medicine and Office of Research, College of Nursing, East Carolina University, Greenville, NC.
authors.forename: Jimmy T
authors.initials: JT
authors.lastname: Efird
authors.affiliation: Department of Radiation Oncology, University of North Carolina, Chapel Hill, Chapel Hill, NC.
authors.forename: Shreya
authors.initials: S
authors.lastname: Prasad
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Rochester, MN.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: James
authors.affiliation: Department of Public Health, East Carolina University, Greenville, NC; Division of Medical Oncology, Department of Medicine, East Carolina University, Greenville, NC.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Walker
authors.affiliation: Department of Radiation Oncology, University of North Carolina, Chapel Hill, Chapel Hill, NC.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Zagar
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D012189:Retrospective Studies; D064726:Triple Negative Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology*
keywords: Inflammatory breast cancer; Neoadjuvant chemotherapy; Pathological complete response; Survival; Triple negative