Inflammatory breast cancer response to modern neoadjuvant chemotherapy: Tumor response and survival outcomes

Background

Inflammatory breast cancer (IBC) is a rare, aggressive form of breast cancer. This study evaluates oncologic outcomes in IBC patients treated with modern multimodal treatment.

Methods

A retrospective review analyzed clinicopathologic data of 5063 patients, 646 of whom underwent NAC followed by surgery between 2012 and 2024. Survival outcomes were compared across biologic subtypes.

Results

Twenty-six cases of T4dM0 IBC were identified, with 57.7 ​% HER-2 positive, 26.9 ​% ER positive/HER-2 negative, and 15.4 ​% ER negative/HER-2 negative. The total pCR rate was highest in HER-2 positive (53.3 ​%) and lowest in ER-positive/HER-2 negative patients (p ​= ​0.036). Among 19 patients with ≥3 years of follow-up, 47 ​% experienced recurrence (78 ​% distant and 22 ​% locoregional) and 42 ​% died of breast cancer. No significant differences in locoregional recurrence, or survival outcomes were found across subtypes.

Conclusion

pCR has limited prognostic value in IBC. Although HER-2 positive patients are more likely to achieve pCR, this does not necessarily translate into improved outcomes.