INFLAMMATORY BREAST-CANCER

Inflammatory breast cancer has historically carried a poor prognosis. This has led to the development of multimodal protocols in an attempt to improve survival. Twenty-three women were treated for inflammatory breast cancer at our institution between 1979 and 1992. The mean age a t diagnosis was 55.8 years (40 to 77 years). Eighteen women (78%) pres ented clinically with an erythematous or swollen and tender breast, an d 19 (80%) had pathologically demonstrated dermal lymphatic invasion. Five (21.7%) had evidence of distant metastasis at the time of present ation. Treatment consisted of modified radical mastectomy in 65% of pa tients in combination with preoperative or postoperative chemotherapy. The most common chemotherapeutic regimen was 5-Fluorouracil, Adriamyc in, and Cyclophosphamide. Eleven women (48%) also received chest wall irradiation (4,200 to 6,000 cGy). Eleven women had classic multimodali ty therapy (surgery, chemotherapy, and radiation therapy). Median surv ival is 23.4 months (6 to 77 months). We concluded that with combinati on therapy, selected patients can experience long-term survival; howev er, overall prognosis remains poor, with eventual disease recurrence a nd death resulting from the disease.