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Dermal Lymphatic Invasion, Survival, and Time to Recurrence or Progression in Inflammatory Breast Cancer
Kelly A Hirko1, Meredith M Regan2, Marie C Remolano3
1Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI.
American Journal of Clinical Oncology
|June 21, 2021
Summary
Dermal lymphatic invasion (DLI) is common in inflammatory breast cancer (IBC) but does not independently predict survival or recurrence. This study found no significant association between DLI and patient outcomes in IBC.
Area of Science:
- Oncology
- Pathology
- Medical Research
Background:
- Dermal lymphatic invasion (DLI) with tumor emboli is a frequent characteristic of inflammatory breast cancer (IBC).
- However, DLI is not a mandatory diagnostic criterion for IBC.
- Its prognostic significance for clinical outcomes remains to be fully elucidated.
Purpose of the Study:
- To investigate the association between documented DLI on skin biopsy and survival outcomes in patients with IBC.
- To determine if DLI correlates with time to recurrence or progression in inflammatory breast cancer.
Main Methods:
- A cohort of 340 women with IBC was analyzed from the IBC Registry at Dana-Farber Cancer Institute (1997-2019).
- Kaplan-Meier curves and multivariable Cox proportional hazards models were employed.
- Associations between DLI and overall survival, locoregional recurrence/progression, and distant metastasis were assessed by stage at presentation.
Main Results:
- DLI was detected in 63.2% of IBC cases.
- IBC with DLI showed higher prevalence of de novo metastases, skin ulceration, and lymphovascular invasion within the breast, but less palpable mass at presentation.
- Over a median follow-up of 2.0 years, DLI was not significantly associated with survival or recurrence in multivariable models (P ≥0.10).
Conclusions:
- While DLI may relate to certain biological features of IBC, it was not found to be an independent prognostic marker for clinical outcomes in this study.
- The presence of tumor emboli in dermal lymphatics does not appear to independently impact survival or recurrence rates in inflammatory breast cancer patients.
