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 inflammatory breast cancer and were treated with curative intent between October 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 with radiotherapy, chemotherapy, and surgery (n = 33) had a 5-year relapse-free survival rate of 50 per cent, compared with 7 per cent for those patients (n = 17) who received less treatment (P = 0.0002). The only clinical factor with a negative impact on relapse-free survival was mass size > 5 cm (P = 0.07). No advantage could be demonstrated for preoperative chemotherapy over postoperative chemotherapy or for doxorubicin-containing regimens over cyclophosphamide, methotrexate, and 5-fluorouracil. There was no difference in the incidence of distant metastases for patients receiving preoperative rather than postoperative chemotherapy, but there were more local recurrences in patients in whom local-regional treatment was delayed. A higher rate of arm edema was associated with more extensive surgery.