RESULTS OF MULTIMODALITY THERAPY FOR INFLAMMATORY BREAST-CANCER - AN ANALYSIS OF CLINICAL AND TREATMENT FACTORS AFFECTING OUTCOME

This is a retrospective analysis of 50 patients with a minimum 2-year follow-up who had clinical signs and/or histologic evidence of inflamm atory breast cancer and were treated with curative intent between Octo ber 1964 and March 1989. The 5-year relapse-free, absolute, and cause- specific survival rates for the overall group of 50 patients were 36, 39, and 45 per cent, respectively. Patients who received treatment wit h radiotherapy, chemotherapy, and surgery (n = 33) had a 5-year relaps e-free survival rate of 50 per cent, compared with 7 per cent for thos e patients (n = 17) who received less treatment (P = 0.0002). The only clinical factor with a negative impact on relapse-free survival was m ass size > 5 cm (P = 0.07). No advantage could be demonstrated for pre operative chemotherapy over postoperative chemotherapy or for doxorubi cin-containing regimens over cyclophosphamide, methotrexate, and 5-flu orouracil. There was no difference in the incidence of distant metasta ses for patients receiving preoperative rather than postoperative chem otherapy, but there were more local recurrences in patients in whom lo cal-regional treatment was delayed. A higher rate of arm edema was ass ociated with more extensive surgery.