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Lymph node status in inflammatory breast cancer

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Abstract

Positive lymph node status in breast cancer is known to be an adverse prognostic factor, but the effect of lymph node (LN) status in inflammatory breast cancer (IBC) has not been evaluated. This study was designed to investigate the association between lymph node status and overall survival (OS) in individuals with IBC. Using the Surveillance, Epidemiology, and End Results (SEER) 18 registry, we collected data on 761 patients diagnosed with non-metastatic IBC from 2004 to 2008. Survival analysis was performed using the Kaplan–Meier method. Cox proportional hazard regression was performed to evaluate univariate and multivariate associations between estrogen and progesterone receptor (ER/PR) status, treatment, and OS. Positive nodal status was associated with a significant decrease in OS (p < 0.001). Five-year survival for LN-positive and LN-negative patients was 49 and 66 %, respectively. In node-positive patients, ER or PR positivity was associated with improved OS, (p = 0.025, p = 0.007). In node-positive patients, the combination of surgery and radiation therapy improved OS when compared with surgery alone (p = 0.002). Nearly 80 % of the patients in this study had nodal metastasis. Positive nodal status was found to be an adverse prognostic factor. ER/PR positivity and treatment with surgery and radiation in node-positive patients was found to improve outcomes. Further studies are required to characterize the biology of IBC and guide the optimal treatment of this disease.

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Acknowledgments

This project was supported in part by SC CTSI (NIH/NCATS) through Grant UL1TROOO130 and P30CA014089 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institute of Health.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Breast and Soft Tissue Surgery, Department of Surgery, Norris Comprehensive Cancer Center, University of Southern California, 1450 Biggy Street, Norris Research Tower (NRT) 3505, Los Angeles, CA, 90033, USA

    Julie S. Wecsler, Ryan R. Woods, Stephen F. Sener & Julie E. Lang

  2. Department of Radiation Oncology, U.T. MD Anderson Cancer Center, Houston, TX, USA

    Welela Tereffe

  3. Department of Surgery, University of Arizona Cancer Center, Tucson, AZ, USA

    Rose C. Pedersen, Michelle R. Sieffert & Rebecca K. Viscusi

  4. Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA

    Wendy J. Mack

  5. Department of Biometry, University of Arizona Cancer Center, Tucson, AZ, USA

    Haiyan Cui

  6. Division of Medical Oncology, Department of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA

    Christy A. Russell

Authors
  1. Julie S. Wecsler
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  2. Welela Tereffe
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  3. Rose C. Pedersen
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  4. Michelle R. Sieffert
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  7. Christy A. Russell
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  8. Ryan R. Woods
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  10. Stephen F. Sener
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  11. Julie E. Lang
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Correspondence to Julie E. Lang.

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Wecsler, J.S., Tereffe, W., Pedersen, R.C. et al. Lymph node status in inflammatory breast cancer. Breast Cancer Res Treat 151, 113–120 (2015). https://doi.org/10.1007/s10549-015-3367-6

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  • DOI: https://doi.org/10.1007/s10549-015-3367-6

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