Long-term Follow-up of Breast Conserving Therapy in Inflammatory Breast Cancer Patients Treated with Neoadjuvant Chemotherapy

Inflammatory Breast Cancer (IBC) is a rare and aggressive form of breast cancer. Currently, multimodality treatment is recommended, but the optimal surgical management has not been fully elucidated. In this study, we investigated the long-term outcomes of utilizing breast conserving therapy in IBC patients undergoing neoadjuvant chemotherapy (NAC). 24 patients with IBC were treated from 2002 to 2006. NAC was initiated with doxorubicin and cyclophosphamide followed by paclitaxel. In addition, HER2/neu positive patients received trastuzumab while HER2/neu negative patients received bevacizumab. Clinical response was assessed by dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) prior to surgery and pathologic response following surgery. A partial mastectomy with sentinel lymph node biopsy and/or axillary lymph node dissection or a modified radical mastectomy was performed based on the surgeon's recommendations and patient's preference. All patients received adjuvant radiation. Of the 24 patients, 7 (29%) underwent a partial mastectomy and 17 (71%) underwent a mastectomy. The overall survival rate for partial mastectomy and for mastectomy patients was 59% and 57% (pvalue= 0.49), respectively, at a median follow-up of 60 months (range 48-92 months). Breast conserving therapy can be considered in a selected group of patients who demonstrate a good response to NAC.