PROGNOSTIC FACTORS IN INFLAMMATORY BREAST-CANCER AND THERAPEUTIC IMPLICATIONS

223 inflammatory breast cancer patients were diagnosed at the Institut Curie between 1977 and 1987. Patients received chemotherapy and radia tion treatment according to three consecutive randomised trials. Five- and 10-year survival rates were 41 and 32%, respectively. Disease-fre e interval rates were 25.5% at 5 years and 19% at 10 years. Parameters significantly linked with a pejorative prognosis in a multivariate an alysis were: diffuse erythema, lymph node involvement, chest wall adhe rence, and age above 50 years. When therapeutic response parameters we re included in the multivariate analysis, the five most important prog nostic factors in order of significance were complete tumour regressio n after completion of induction treatment (at 8 months), complete regr ession of inflammatory symptoms after 3 months of neoadjuvant chemothe rapy, limited erythema at presentation and, less significantly, comple te regression of inflammatory symptoms at 8 months and tumour regressi on at 3 months, in conclusion, patients who achieved a rapid and compl ete remission had a better prognosis than patients who had an incomple te response to chemotherapy. High-dose chemotherapy and reversal or pr evention of drug resistance will be evaluated in future trials. Detail ed information on the biology of this disease should allow the design of new strategies aiming to improve patient management.