The following article features coverage from the 2021 San Antonio Breast Cancer Symposium. Click here to read more of MPR‘s conference coverage.

 

A modern approach to treatment of inflammatory breast cancer may improve patient outcomes compared with historical standards among patients with estrogen receptor (ER)-positive/HER2-positive disease, according to a retrospective study presented at the 2021 San Antonio Breast Cancer Symposium (SABCS).

The 5-year relapse-free survival (RFS) for patients with inflammatory breast cancer is approximately 40% with standard treatment of neoadjuvant chemotherapy, surgery, and postmastectomy radiation. The aim of this study was to evaluate response to more modern therapies and breast reconstruction.

The retrospective registry study evaluated 68 patients with inflammatory breast cancer diagnosed between 2006 and 2019 at a single institution. The median follow-up was 1.83 years.

At baseline, the median age was 55 and tumors were ER-negative/HER2-negative, ER-negative/HER2-positive, and ER-positive/HER2-positive. The majority of patients (52.9%) received doxorubicin plus cyclophosphamide and paclitaxel as their neoadjuvant chemotherapy regimen.

The pathologic complete response (pCR) for the entire cohort after neoadjuvant chemotherapy was 27.9%. Pathologic CR was highest in patients with ER-negative/HER2-positive disease (41.2%); the lowest rate (18.2%) was in patients with ER-positive/HER2-positive disease. Of the patients who underwent breast reconstruction (34.3%), 24.3% underwent immediate reconstruction and 10.0% underwent reconstruction delayed by at least 1 year after mastectomy.

The shortest 5-year RFS was reported in patients with ER-negative/HER2-negative disease (28%), whereas RFS was longer in patients with ER-positive/HER2-negative, ER-positive/HER2-positive, and ER-negative/HER2-positive disease (58% to 65%), albeit this was not significant (P =.06).

RFS was significantly longer for patients who achieved pCR compared with patients who experienced no response or only a partial response to neoadjuvant therapy (P =.038).

Breast reconstruction, either immediately following surgery or delayed by at least 1 year, did not affect RFS. However, immediate breast reconstruction was associated with higher complication rates compared with patents who did not undergo reconstruction (35.3% vs 6.3%, respectively; P =.012).

The researchers concluded that “with modern approach to treatment, patients with ER-positive/HER2-positive breast cancer have encouraging survival outcomes compared to historical standards.” However, they added that “patients with ER-negative/HER2-negative inflammatory breast cancer continue to have poor outcomes.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Tran J, Valente S, Tu C, Kruse M. Management trends and outcomes assessment for inflammatory breast cancer. Presented at SABCS 2021; December 7 to 10, 2021; San Antonio, TX. Abstract P1-24-07.

This article originally appeared on Cancer Therapy Advisor