Secondary inflammatory breast cancer: treatment options

Patients with inflammatory breast cancer (IBC) have either a short history of a tender, swollen, red breast (primary IBC) or skin changes that develop in the breast after a long history of carcinoma (secondary IBC). Between 1954 and 1981, 96 patients with secondary IBC were given radiotherapy (n = 66), chemotherapy and radiotherapy (n = 16), or surgery and chemotherapy (n = 14) at M. D. Anderson Hospital. The overall survival rate was 36% at five years and 18% at ten years. Patients with clinically negative axillary nodes fared better than patients with involved axillary nodes (median survival 90 and 25 months respectively; chi 2 = 11.71, P less than .001). Local/regional control was achieved in 63% of the radiotherapy group, 75% of the chemotherapy and radiotherapy group, and 93% of the surgery and chemotherapy group (chi 2 = 7.12, P greater than .03). No survival advantage could be found between the three treatment groups (median survival rate was 32, 28, and 36 months respectively; chi 2 = .789, P greater than .673). When we compared these patients with a group of patients who had primary IBC treated at this institution, we found no major differences in clinical course or survival rate. The distinction between primary and secondary IBC appears to be of little prognostic value.