Inflammatory breast cancer in the Netherlands: improved survival over the last decades

D.J.P. Van Uden, R. Bretveld, S. Siesling, J.H.W. de Wilt, C.F.J.M. Blanken-Peeters

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)

Abstract

Purpose: Locally advanced breast cancer (LABC) includes inflammatory breast cancer (IBC) as well as non-inflammatory LABC (NI-LABC). The aim of this population-based study was to compare the tumour characteristics, treatment and relative survival of IBC and NI-LABC patients.
Methods: Patients with either IBC (cT4d) or NI-LABC (cT4a–c) were identified from the nationwide Netherlands Cancer Registry from the period 1989–2015. In each group, patients are divided into three time periods in order to perform a trend analysis: 1989–1997, 1998–2006, and 2007–2015.
Results: IBC comprised 1.1% and NI-LABC 4.6% of all diagnosed breast cancer patients. IBC patients showed more nodal metastases (77.8 vs. 69.7%, P < 0.001) and distant metastases (39.7 vs. 34.1%, P < 0.001). IBC tumours were more often triple negative (23.2 vs. 12.8%, P < 0.001) and poorly differentiated (69.8 vs. 53.8%, P < 0.001). Trimodality therapy (neoadjuvant chemotherapy, surgery and adjuvant radiotherapy) was more often applied over time in both groups (IBC: 23.7%–56.0%–68.6%; NI-LABC: 3.7%–25.9%–43.6%; Ptrend < 0.001). In IBC patients, relative 5-year survival was significantly shorter than in patients with NI-LABC (30.2 vs. 45.1%, P < 0.001). The relative survival significantly improved for IBC from 17.2% (1989–1997) to 30.0 and 38.9% for the last two time periods (1998–2006: P < 0.001; 2007–2015: P < 0.001). In contrast, survival did not significantly improve in NI-LABC breast cancer: from 44.7% (1989–1997) to 44.0 and 48.4% (1998–2006: P = 0.483; 2007–2015: P = 0.091).
Conclusions: IBC has tumour characteristics that determine its aggressive biology compared to NI-LABC. Trimodality therapy was increasingly applied in both groups, but did not improve survival in NI-LABC. Although relative survival in IBC patients has improved during the last decades, it remains a disease with a dismal prognosis.
Original languageEnglish
Pages (from-to)365-374
JournalBreast cancer research and treatment
Volume162
Issue number2
DOIs
Publication statusPublished - 30 Jan 2017

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