287P Clinico-pathological features and survival outcome of inflammatory breast cancer: An Indian scenario

Inflammatory breast cancer (IBC) is an aggressive form of locally advanced breast cancer with high metastatic potential and accounts for 2-4% of all newly diagnosed cases of breast cancer in the West. Data on prevalence, clinical-pathological parameters, the pattern of distant metastasis, and outcomes are lacking from India. We retrospectively screened 7900 breast cancer cases registered from January 2006 to December 2020 and found 80 cases of IBC at All India Institute of Medical Sciences (AIIMS), New Delhi, India. Overall survival (OS) was defined as the period between diagnosis and death from any cause. Relapse-free survival (RFS) was defined as the period from diagnosis to the occurrence of relapse in nonmetastatic disease. Progression-free survival (PFS) was defined as the period from diagnosis to the occurrence of relapse or progression in metastatic disease. The median age was 44 years (range 22-69). The median duration of symptoms was 6 months. The American Joint Committee on Cancer stage (AJCC) distribution was Stage III – 60 (75%) and IV – 20(25%) patients. Estrogen receptor (ER) and/or progesterone receptor (PR) positivity and human epidermal growth factor receptor 2 (HER2/neu) positivity were 50% and 55%, respectively. Triple negativity was found in 17% of the cases. All the nonmetastatic IBC patients received neoadjuvant sequential anthracycline and taxane-based chemotherapy followed by a modified radical mastectomy, radiotherapy, and hormonal therapy as indicated. Targeted therapy was used in 20% of cases. With a median follow-up of 42 months and 3 years, RFS and OS were 30% and 40% respectively. Lung and brain were the most common sites for systemic relapse. The 3 years PFS and OS were 15% and 20% respectively for metastatic disease and the brain was the most common site for systemic progression. IBC constituted around 1% of all breast cancer patients at our center. Her2 neu positivity was found to have in 55 % of cases and non-availability of targeted treatment resulted in a poor outcome. Overall brain is the most common site of metastasis or progression. Prophylactic radiation to the brain, might be helpful in IBC patients, living in limited resources where trastuzumab is not freely available.