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Abstract
Sixty-eight patients with inflammatory breast carcinoma (IBC) received treatment in
2 prospective randomized trials of multimodality therapy for locally advanced breast
cancer. The treatment plan consisted of 3 courses of neoadjuvant chemotherapy with
CAF (cyclophosphamide/doxorubicin/5-fluorouracil [5-FU]) or CEF (cyclophosphamide/
epirubicin/5-FU) followed by surgery and 6 adjuvant courses of CAF or CEF alternated
with CMF (cyclophosphamide/methotrexate/5-FU). Radiation therapy was administered
at the end of adjuvant treatment. All patients with estrogen receptor—positive tumors
received tamoxifen 20 mg daily for 5 years. The response rate to induction chemotherapy
was 73.6% (95% CI, 61.4%–83.5%): 4 of 68 patients (6%) exhibited a pathologic remission
of primary breast tumor (persistent disease in the axilla), and 2 patients (3%) exhibited
a pathologic complete response. Median follow-up was 10 years (range, 5 months to
14.7 years). Diseasefree survival (DFS) rates at 5 and 10 years were 29% and 20%,
respectively, and median DFS was 2.2 years (range, 3.8 months to 11.5 years). Overall
survival (OS) rates at 5 and 10 years were 44% and 32%, respectively, and median OS
was 4 years (range, 5 months to 14.7 years). Significant prognostic factors for DFS
and OS were the number of axillary nodes and residual disease in the breast at surgery.
This analysis confirmed that patients with IBC obtained significant long-term survival
benefit from combined-modality therapy.
Key words
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Article info
Publication history
Accepted:
October 16,
2003
Received in revised form:
October 6,
2003
Received:
July 17,
2003
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
