An analysis of disease-free survival and overall survival in inflammatory breast cancer

OBJECTIVE: To examine if Inflammatory Breast Cancer (IBC) have worse disease-free and overall survival than non-Inflammatory Breast Cancer (non-IBC) patients. ❧ METHODS: Overall survival (OS) and disease-free survival (DFS) and locoregional control survival (LRC) were compared between IBC and non-Inflammatory Breast Cancer (non-IBC) Stage III patients. OS and progression-free survival (PFS) were compared between IBC and non-IBC Stage IV patients. Univariate analysis was first done by OS and DFS analyses with Kaplan Meier method for all IBC and non-IBC patients. Cox proportional hazards regression modeling was then used to obtain hazard ratios and likelihood ratio p-values. Cumulative incidence analysis was used to estimate and compare rates of different competing risks for IBC and non-IBC patients. Multivariate analyses through Cox proportional hazard regression modeling and likelihood ratio tests were performed to determine the important prognostic factors for overall survival and disease-free survival. ❧ RESULTS: For Stage III patients, OS, DFS and LRC were highly significantly different between IBC and non-IBC patients (p=0.0032, p=0.0005 and p=0.0012, respectively). Race, tumor histology, estrogen receptor status, and tumor size were significantly associated with both OS and DFS in multivariate analysis. African American race, invasive ductal histology, ER-negative receptor status, and larger tumor size were associated with poorer survival. ❧ CONCLUSION: IBC is an aggressive breast cancer with high recurrence rate and poor clinical prognosis. Stage III IBC patients have a poorer survival outcome than Stage III non-IBC patients. Further studies need to be done on the prognostic factors for IBC patients.