BACKGROUND: We studied whether dermal lymphatic emboli (DLE) add independent prognostic information to the clinical definition of inflammatory breast cancer (IBC). PATIENTS AND METHODS: The study was performed in 2 centers, one each in France and Tunisia. For every patient with IBC, 1-3 patients with noninflammatory breast cancer (non-IBC) were included. All patients were to have a surgical tumor biopsy, including a sample of the skin surrounding the tumor. The endpoint was the risk of a relapse at 2 years, which was estimated using univariate and multivariate Cox models. RESULTS: Three hundred thirty-seven patients were included (150 in France and 187 in Tunisia). The IBC status was divided into 2 clinical categories according to the extent of inflammation in the breast (localized IBC, which was defined as clinical inflammation in the tumor area, vs. diffuse IBC, which was defined as inflammation of at least two thirds of the breast). In total, 57 patients presented with localized IBC, 71 with diffuse IBC, and 209 with non-IBC. Dermal lymphatic emboli were found in 7% of non-IBC cases, in 25% of localized IBC cases, and in 45% of diffuse IBC cases. We found a significant interaction between the presence of DLE and diffuse IBC (P = 0.01). In patients with diffuse IBC, the presence of DLE increased the risk of relapse 3-fold. Conversely, DLE were not associated with the risk of relapse in patients with non-IBC, nor in patients with localized IBC. In patients with diffuse IBC and no DLE, the risk of relapse was similar to that of patients with localized IBC. CONCLUSION: A DLE status might be a useful prognostic indicator exclusively in patients with diffuse IBC. However, because all patients with localized and diffuse IBC generally receive similar types of treatment, additional information on the presence or absence of DLE will not have an impact on treatment practice.
BACKGROUND: We studied whether dermal lymphatic emboli (DLE) add independent prognostic information to the clinical definition of inflammatory breast cancer (IBC). PATIENTS AND METHODS: The study was performed in 2 centers, one each in France and Tunisia. For every patient with IBC, 1-3 patients with noninflammatory breast cancer (non-IBC) were included. All patients were to have a surgical tumor biopsy, including a sample of the skin surrounding the tumor. The endpoint was the risk of a relapse at 2 years, which was estimated using univariate and multivariate Cox models. RESULTS: Three hundred thirty-seven patients were included (150 in France and 187 in Tunisia). The IBC status was divided into 2 clinical categories according to the extent of inflammation in the breast (localized IBC, which was defined as clinical inflammation in the tumor area, vs. diffuse IBC, which was defined as inflammation of at least two thirds of the breast). In total, 57 patients presented with localized IBC, 71 with diffuse IBC, and 209 with non-IBC. Dermal lymphatic emboli were found in 7% of non-IBC cases, in 25% of localized IBC cases, and in 45% of diffuse IBC cases. We found a significant interaction between the presence of DLE and diffuse IBC (P = 0.01). In patients with diffuse IBC, the presence of DLE increased the risk of relapse 3-fold. Conversely, DLE were not associated with the risk of relapse in patients with non-IBC, nor in patients with localized IBC. In patients with diffuse IBC and no DLE, the risk of relapse was similar to that of patients with localized IBC. CONCLUSION: A DLE status might be a useful prognostic indicator exclusively in patients with diffuse IBC. However, because all patients with localized and diffuse IBC generally receive similar types of treatment, additional information on the presence or absence of DLE will not have an impact on treatment practice.
Authors: Nabila Chaher; Hugo Arias-Pulido; Nadija Terki; Clifford Qualls; Kamel Bouzid; Claire Verschraegen; Anne Marie Wallace; Melanie Royce Journal: Breast Cancer Res Treat Date: 2011-03-01 Impact factor: 4.872
Authors: Paul H Levine; Chia C Portera; Heather J Hoffman; Sherry X Yang; Mikiko Takikita; Quyen N Duong; Stephen M Hewitt; Sandra M Swain Journal: Clin Breast Cancer Date: 2012-06-12 Impact factor: 3.225
Authors: Catherine Schairer; Ahmed Hablas; Ibrahim AbdelBar Seif Eldein; Rabab Gaafar; Henda Rais; Amel Mezlini; Farhat Ben Ayed; Wided Ben Ayoub; Abdellatif Benider; Ali Tahri; Mouna Khouchani; Dalia Aboulazm; Mehdi Karkouri; Saad Eissa; Ruth M Pfeiffer; Shahinaz M Gadalla; Sandra M Swain; Sofia D Merajver; Linda Morris Brown; Amr S Soliman Journal: Breast Cancer Res Treat Date: 2019-04-22 Impact factor: 4.872
Authors: An-Chi Lo; Celina G Kleer; Mousumi Banerjee; Sherif Omar; Hussein Khaled; Saad Eissa; Ahmed Hablas; Julie A Douglas; Sharon H Alford; Sofia D Merajver; Amr S Soliman Journal: Breast Cancer Res Treat Date: 2007-12-04 Impact factor: 4.872
Authors: K Raghav; J T French; N T Ueno; X Lei; S Krishnamurthy; J M Reuben; V Valero; N K Ibrahim Journal: PLoS One Date: 2016-01-11 Impact factor: 3.240
Authors: Kelly A Hirko; Amr S Soliman; Mousumi Banerjee; Julie Ruterbusch; Joe B Harford; Robert M Chamberlain; John J Graff; Sofia D Merajver; Kendra Schwartz Journal: Springerplus Date: 2013-01-07