Evaluating breast removal surgery in stage IV inflammatory breast cancer.

This study looked at the use of modified radical mastectomy (MRM) in the treatment of newly diagnosed stage IV inflammatory breast cancer (IBC). The authors found that MRM is associated with improved survival in these patients.  

IBC is a rare and aggressive cancer that affects 2.0-2.5% of women with BC. 25-29% of women with IBC have stage IV disease at diagnosis. Standard treatment for IBC is usually chemo-radiotherapy, surgery, and targeted therapies. 

MRM is a procedure in which the entire breast is removed, including the skin, areola, nipple, and most underarm lymph nodes. The use of MRM in the management of newly diagnosed stage IV IBC has remained controversial until now. 

97 women with newly diagnosed stage IV IBC were included in this study. All patients had received systemic (whole-body) therapy. 52 of these patients also underwent MRM at an average 7.5 months after diagnosis. 45 patients did not have surgery. The average follow-up for the entire group was 65.9 months.

The average survival of patients in the non-surgery group was 19 months compared to 58 months in the MRM group. Patients with HER2-positive status (tumor have on their surface the HER2 protein) had better survival compared to those with HER2-negative tumors. Also, patients with fewer lymph nodes involved had better survival chances. 

Patients who had a good response to systemic therapy before surgery had a 57% higher better survival. MRM surgery was also associated with a 48% higher chance of a better survial.

The authors concluded that MRM is associated with improved survival in patients with newly diagnosed stage IV IBC. 

This study was based on medical records. The choice of treatment was not randomized. The spread of the tumor to the lungs was more common in the non-surgical group than the surgical group. These factors may have influenced the results.