Case series of inflammatory breast cancer in two Greek hospitals: our experience and critical appraisal

Inflammatory breast cancer (IBC) represents a very aggressive type of locally advanced cancer. Because of its rarity, management of IBC appears heterogeneous; thus, reporting experiences from different clinics can be helpful. Fourteen female patients with IBC in two clinics of Greek hospitals were included in this case series study. The type of surgery performed in the eight patients that underwent surgery was modified radical mastectomy after neoadjuvant chemotherapy. Moreover, lymph node excision (level one and two) was performed in all (n=14) patients; all but one patients had positive lymph nodes. Sentinel biopsy technique was avoided in the above female patients with IBC. Radiotherapy was applied to all patients, except one elderly patient. Second-line chemotherapy was applied in three patients with aggressive, recurrent tumors. Two patients out of 14 (~14.3%) died within 3 years after initial treatment, 2 patients are alive (~14.3%) with recurrence after 5 years, and 10 patients are still alive (~71.4%) with no clinically apparent recurrence. Four patients (~28.6%) had local recurrence; among them, two (~14.3% out of total) were treated with lumpectomy, and two (~14.3%) were diagnosed with distant metastasis. Second line chemotherapy was applied to 4 (~28.6%) patients. In addition, IBC cases represented around 2% of the total number of female patients with breast cancer in our centers. Patients with IBC who were treated with multimodal management (i.e., chemotherapy and surgical treatment) did not have higher disease-free survival rates compared to those treated with chemotherapy alone. According to our experience, and in contrast to the typical low prognosis of IBC, the aggressive management of patients with IBC leads to relatively high prognosis rates and high level of disease-free survival in our case series. This approach needs to be assessed in larger clinical settings within the broader aim of exploring potential new approaches in management of patients with IBC.