Metastatic inflammatory breast cancer: survival outcomes and prognostic factors in the national, multicentric, and real-life French cohort (ESME).

Abstract

BACKGROUND:

Primary inflammatory breast cancer (IBC) is a rare and aggressive entity whose prognosis has been improved by multimodal therapy. However, 5-year overall survival (OS) remains poor. Given its low incidence, the prognosis of IBC at metastatic stage is poorly described.

MATERIALS AND METHODS:

This study aimed to compare OS calculated from the diagnosis of metastatic disease between IBC patients and non-IBC patients in the Epidemiological Strategy and Medical Economics database (N = 16 702 patients). Secondary objectives included progression-free survival (PFS) after first-line metastatic treatment, identification of prognostic factors for OS and PFS, and evolution of survival during the study period.

RESULTS:

From 2008 to 2014, 7465 patients with metastatic breast cancer and known clinical status of their primary tumor (T) were identified (582 IBC and 6883 non-IBC). Compared with metastatic non-IBC, metastatic IBC was associated with less hormone receptor-positive (44% versus 65.6%), more human epidermal growth factor receptor 2-positive (30% versus 18.6%), and more triple-negative (25.9% versus 15.8%) cases, more frequent de novo M1 stage (53.3% versus 27.7%; P < 0.001), and shorter median disease-free interval (2.02 years versus 4.9 years; P < 0.001). With a median follow-up of 50.2 months, median OS was 28.4 months [95% confidence interval (CI) 24.1-33.8 months] versus 37.2 months (95% CI 36.1-38.5 months) in metastatic IBC and non-IBC cases, respectively (P < 0.0001, log-rank test). By multivariate analysis, OS was significantly shorter in the metastatic IBC group compared with the metastatic non-IBC group [hazard ratio = 1.27 (95% CI 1.1-1.4); P = 0.0001]. Survival of metastatic IBC patients improved over the study period: median OS was 24 months (95% CI 20-31.9 months), 29 months (95% CI 21.7-39.9 months), and 36 months (95% CI 27.9-not estimable months) if diagnosis of metastatic disease was carried out until 2010, between 2011 and 2012, and from 2013, respectively (P = 0.003).

CONCLUSION:

IBC is independently associated with adverse outcome when compared with non-IBC in the metastatic setting.

• Authors: D Dano, A Lardy-Cleaud, A Monneur, N Quenel-Tueux, C Levy, M-A Mouret-Reynier, B Coudert, A Mailliez, J-M Ferrero, S Guiu, M Campone, T de La Motte Rouge, T Petit, B Pistilli, F Dalenc, G Simon, F Lerebours, S Chabaud, F Bertucci, A Gonçalves
• Journal: ESMO open (ESMO Open) Vol. 6 Issue 4 Pg. 100220 (08 2021) ISSN: 2059-7029 [Electronic] England
• PMID: 34303929 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

Topics

• Cohort Studies
• Humans
• Inflammatory Breast Neoplasms (epidemiology, therapy)
• Prognosis
• Progression-Free Survival
• Retrospective Studies