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Int. J. Environ. Res. Public Health 2019, 16(1), 124; https://doi.org/10.3390/ijerph16010124

Pathologic Complete Response (pCR) and Survival of Women with Inflammatory Breast Cancer (IBC): An Analysis Based on Biologic Subtypes and Demographic Characteristics

1
Department of Radiation Oncology, University Hospitals, Case Western Reserve University, Cleveland, OH 44106, USA
2
Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health, The University of Newcastle (UoN), Newcastle 2308, Australia
3
Surgical Oncology, Maine Medical Center Cancer Institute, Scarborough, ME 04074, USA
4
Priority Research Centre for Generational Health and Ageing (PRCGHA), School of Medicine and Public Health, The University of Newcastle (UoN), Newcastle 2308, Australia
*
Author to whom correspondence should be addressed.
Received: 2 November 2018 / Revised: 3 December 2018 / Accepted: 28 December 2018 / Published: 4 January 2019
(This article belongs to the Section Women's Health)
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Abstract

In this US-based study of the National Cancer Database (NCDB), we examined 8550 patients diagnosed with non-metastatic, invasive inflammatory breast cancer (IBC) who received surgery from 2004–2013. Patients were grouped into four biologic subtypes (HR+/HER2, HR+/HER2+, HR/HER2+, HR/HER2). On average, women were 56 years of age at diagnosis and were followed for a median of 3.7 years. The majority were white (80%), had private health insurance (50%), and presented with poorly differentiated tumors (57%). Approximately 46% of the cancers were >5 cm. Most patients underwent mastectomy (94%) and received radiotherapy (71%). Differences by biologic subtypes were observed for grade, lymph node invasion, race, and tumor size (p < 0.0001). Patients experiencing pathologic complete response (pCR, 12%) vs. non-pCR had superior 5-year overall survival (OS) (77% vs. 54%) (p < 0.0001). Survival was poor for triple-negative (TN) tumors (37%) vs. other biologic subtypes (60%) (p < 0.0001). On multivariable analysis, TN-IBC, positive margins, and not receiving either chemotherapy, hormonal therapy or radiotherapy were independently associated with poor 5-year survival (p < 0.0001). In this analysis of IBC, categorized by biologic subtypes, we observed significant differential tumor, patient and treatment characteristics, and OS. View Full-Text
Keywords: biologic subtypes; diagnosis; inflammatory breast cancer; pCR; survival biologic subtypes; diagnosis; inflammatory breast cancer; pCR; survival
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Biswas, T.; Jindal, C.; Fitzgerald, T.L.; Efird, J.T. Pathologic Complete Response (pCR) and Survival of Women with Inflammatory Breast Cancer (IBC): An Analysis Based on Biologic Subtypes and Demographic Characteristics. Int. J. Environ. Res. Public Health 2019, 16, 124.

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