Highlights
- •71% of patients diagnosed with IBC had a skin punch biopsy positive for dermal lymphatic invasion.
- •Patients with IBC had a 26% incidence of triple negative and 40% HER 2 positive tumor biology.
- •Patients with a positive skin biopsy had a significantly higher incidence of a chest wall recurrence.
- •Overall 5 year survival was 61% with no difference in survival for those with a positive skin biopsy.
Abstract
Background
The oncologic outcomes of patients diagnosed with inflammatory breast cancer (IBC)
based on clinical exam only versus those with dermal lymphatic invasion on skin punch
biopsy may be different and are worth further investigation.
Methods
Patients diagnosed from 2006 to 2021 with IBC at our institution were grouped according
to clinical diagnosis or skin biopsy performed. Oncologic and survival outcomes among
groups were compared.
Results
A total of 72 IBC patients were identified and grouped into 3 categories based on
method of diagnosis: skin biopsy positive (n = 24), skin biopsy negative (n = 10)
and no biopsy performed (n = 38). Skin biopsy positive patients had a higher incidence
of lymphovascular invasion identified on final pathology and were more likely to experience
a chest wall recurrence. At 5.1 yrs of follow-up, 40% of patients experienced recurrence,
with 61% overall survival.
Conclusion
Clinical diagnosis remains diagnostic for IBC, but skin punch biopsy allows for improved
oncologic insight.
Keywords
Abbreviations:
Inflammatory Breast Cancer (IBC), Skin Punch Biopsy (SPB), Dermal Lymphatic Invasion (DLI), Locally Advanced Breast Cancer (LABC)To read this article in full you will need to make a payment
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References
- Trends in inflammatory breast carcinoma incidence and survival: the surveillance, epidemiology, and end results program at the National Cancer Institute.J Natl Cancer Inst. 2005; 97: 966-975
- Inflammatory breast cancer defined: proposed common diagnostic criteria to guide treatment and research.Breast Cancer Res Treat. 2022; 192: 235-243
- Dermal lymphatic invasion, survival, and time to recurrence or progression in inflammatory breast cancer.Am J Clin Oncol. 2021; 44: 449-455
- Pathologic aspects of inflammatory breast carcinoma: part 1. Histomorphology and differential diagnosis.Semin Oncol. 2008; 35: 25-32
- Inflammatory carcinoma of the breast.Surg Gynecol Obstet. 1948; 87: 417-424
- MS-81) (
- Tumor biology correlates with rates of breast-conserving surgery and pathologic complete response after neoadjuvant chemotherapy for breast cancer: findings from the ACOSOG Z1071 (Alliance) Prospective Multicenter Clinical Trial.Ann Surg. 2014; 260 (discussion 14-6): 608-614
- Inflammatory breast carcinoma and noninflammatory locally advanced breast carcinoma: distinct clinicopathologic entities?.J Clin Oncol. 2003; 21: 2254-2259
- Inflammatory breast carcinoma: pathological or clinical entity?.Breast Cancer Res Treat. 2000; 64: 269-273
- Influence of patient, physician, and hospital characteristics on the receipt of guideline-concordant care for inflammatory breast cancer.Cancer Epidemiol. 2016; 40: 7-14
- International consensus on the clinical management of inflammatory breast cancer from the morgan welch inflammatory breast cancer research program 10th anniversary conference.J Cancer. 2018; 9: 1437-1447
- Immediate reconstruction in inflammatory breast cancer: challenging current care.Ann Surg Oncol. 2016; 23: 642-648
Article info
Publication history
Published online: November 11, 2022
Accepted:
November 11,
2022
Received in revised form:
October 24,
2022
Received:
July 8,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.