Inflammatory TNBC Breast Cancer: Demography and Clinical Outcome in a Large Cohort of Patients With TNBC

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Abstract

Inflammatory breast cancer with a triple negative phenotype is a rare clinical entity. We identified triple negative breast cancer (TNBC) with an inflammatory phenotype from a large cohort with TNBC. We analyzed various patient, tumor, and treatment characteristics with inflammatory type and compared them with non-inflammatory but advanced TNBC. We found significantly poor survival outcome for TNBC with inflammatory features compared with non-inflammatory TNBC. The report on inflammatory breast cancer based on receptor expression is quite sparse in medical literature. We hope that our report will give the readers a better understanding of this rare disease.

Introduction:

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.

Patients and 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.

Conclusion:

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.

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