Demographic, clinical, pathological, molecular, treatment characteristics and outcomes of nonmetastatic inflammatory bre
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Experimental Hematology & Oncology
LETTER TO THE EDITOR
Open Access
Demographic, clinical, pathological, molecular, treatment characteristics and outcomes of nonmetastatic inflammatory breast cancer in Morocco: 2007 and 2008 Nabil Ismaili1,2*, Hind Elyaakoubi1, Youssef Bensouda1 and Hassan Errihani1
Abstract We analyze the epidemiological characteristics and outcomes of 72 patients diagnosed with non-metastatic inflammatory breast cancer (IBC) at National Institute of Oncology of Rabat in Morocco, between January 2007 and December 2008. IBC patients represent 5% of all breast cancers (90/1800). The median age of patients was 47 years. Thirty eight patients (53%) had premenoposal status and 69% of the cases had clinical lymph nodes. The dominant pathological funding was infiltrating ductal carcinoma (96%). Most patients had high grade II/III (77.8%), 43.4% of the cases were ER negative and 47.4% of the tumors overexpress the HER2/neu receptor on IHC. Only 48.6% of the patients received completed treatment (chemotherapy [CT], surgery and radiotherapy [RT]) and all patients received anthracycline based neoadjuvant CT, 51.4% of whom received Taxane. Seventy one% of the patients underwent surgery and 54% received RT. The clinical response to CT was 68%. Only 1 (1.4%) patient has pathological complete response (pCR) in the breast and 5 (7%) had pathologically negative lymph-nodes. Patient who achieved pCR was disease free at 27 months. LRRFS, EFS and OS rates at 1–2 years were 90.8%-78.1%, 81.7%-57.5%, and 94.3%-74.6%, respectively. Patients with ER-negative status (EFS: P = 0.043) had poorer outcomes and RT was associated with highly significant increase in LRRFS, EFS and OS (P < 0.0001, P < 0.001 and P = 0.017).
To the editor Inflammatory breast cancer (IBC) is a rare and aggressive clinical form of BC representing less than 2% of all BC in westerns countries. However, in North Africa, the incidence of IBC is higher accounting for more than 5% of all BC. It is diagnosed clinically by the rapid onset of diffuse erythema and edema (peau d’orange) of at least a third of the skin overlying the breast that rapidly extends to the entire breast. IBC appears to behave as an ER-negative subtype and HER2-positive subtype. In addition, studies of molecular biology identified several anomalies such as EGFR1 over-expression. Considering cell-of-origin subtypes, most cases of IBC belong to
* Correspondence: [email protected] 1 Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco 2 Department of Medical Oncology, CHU Mohammed VI of Marrakech, Marrakech, Morocco
the basal, the luminal-B, or the HER2-overexpressing subtype. The treatment of this disease has evolved significantly during the past three decades, incorporating combined modality; chemotherapy, surgery and radiotherapy. The 5- and 10-year overall survival rate was 56% and 35%, respectively for patients who have received multimodal therapy [1-4]. From 1800 patients having the diagnosis of BC registered at the National Institute of Oncology
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