Dopolnilna hormonska terapija bistveno izboljša izid bolezni pri hormonsko odvisnem vnetnem raku dojke / Adjuvant hormonal therapy significantly improved outcome in patients with hormonal receptor positive inflammatory breast cancer
BACKGROUND: Inflammatory breast cancer (IBC) is a rare but very agressive subtype of breast cancer. More than half of patients have already axillary lymph node metastasis and a third have distant metastasis at the time of diagnosis. Despite multimodality therapy, which include systemic chemotherapy, surgery and radiation therapy, the outcome of IBC is still poor.
AIM: retrospective evaluation of outcome of patients with IBC treated in two different time periods and impact of adjuvant hormonal treatment (HT) on the outcome of IBC.
PATIENTS AND METHODS: we included in our study 118 pts with nonmetastatic IBC, treated in period 1983-87 (group A) and 2001-05 (group B)
RESULTS: patients in group A have been treated with CMF chemotherapy, in group B with anthracyclines (56%), anthracyclines and taxanes in sequence (36%) or CMF (7%). Most of patients had definitive surgery (100 vs. 83%) and adjuvant radiation (73 vs. 81% pts; group A vs. B). Adjuvant HT received 7/27 pts in group A and 28/31 pts in group B with hormonal receptor positive IBC (median duration 5 months in group A, 44 months in group B). Median time to reccurence was 16.9 (group A) and 34.2 months (group B; p=0.01). Median overall survival was 33.8 vs. 56.6 months (p=0.06) in group A vs. B, resp. Patients with endocrine responsive IBC, treated with adjuvant HT, had the longest relapse free and overal survival (89 and 91 months, resp.).
CONCLUSION: Relapse free and overall survival improved from period 1983-87 to 2001-05. The greatest improvement was in endocrine responsive IBC who received adjuvant HT.
Key words: inflammatory breast cancer; adjuvant hormonal therapy; relapse free survival