Inflammatory breast cancer

Inflammatory breast cancer has historically carried a poor prognosis. This has led to the development of multimodal protocols in an attempt to improve survival. Twenty-three women were treated for inflammatory breast cancer at our institution between 1979 and 1992. The mean age at diagnosis was 55.8 years (40 to 77 years). Eighteen women (78%) presented clinically with an erythematous or swollen and tender breast, and 19 (80%) had pathologically demonstrated dermal lymphatic invasion. Five (21.7%) had evidence of distant metastasis at the time of presentation. Treatment consisted of modified radical mastectomy in 65% of patients in combination with preoperative or postoperative chemotherapy. The most common chemotherapeutic regimen was 5-Fluorouracil, Adriamycin, and Cyclophosphamide. Eleven women (48%) also received chest wall irradiation (4,200 to 6,000 cGy). Eleven women had classic multimodality therapy (surgery, chemotherapy, and radiation therapy). Median survival is 23.4 months (6 to 77 months). We concluded that with combination therapy, selected patients can experience long-term survival; however, overall prognosis remains poor, with eventual disease recurrence and death resulting from the disease.