Underuse of trimodality treatment and survival in inflammatory breast cancer (National Cancer Data Base)
In a national registry, only about a third of women with inflammatory breast cancer received all three recommended treatments, chemotherapy, mastectomy and radiotherapy, and those who did lived substantially longer.
Overview
Analysis of 10,197 women with non-metastatic inflammatory breast cancer in the National Cancer Data Base between 1998 and 2010 examining receipt of chemotherapy, surgery and radiotherapy and its association with survival.
Only 58.4 percent received all three modalities in recent years, with wide variation by facility and region; median survival was longest with trimodality therapy, and its use was an independent predictor of survival.
- Trimodality therapy associated with improved overall survival compared with any lesser combination.
- Use of trimodality therapy varied substantially by treatment facility type.
The gap between guideline and practice in inflammatory breast cancer is large; this paper is the reason guidelines insist on referral to centres that deliver the full sequence.
- Registry data with selection bias; healthier patients are more likely to complete all treatments.