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Inflammatory breast cancer: lines of therapy

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5 standard-of-care settings across 3 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersHR-positive
Screening, prevention and diagnosis1·
Advanced, first line1·
Other settings21

Screening, prevention and diagnosis

SubgroupSettingApproachProducts and trialsEvidence
All comersDiagnosis and stagingSkin punch biopsy and core biopsy with receptor testing, clinical photography, bilateral mammography and ultrasound, and PET-CT or CT with bone scan because distant spread is common at presentation.95

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersSystemic therapy firstAnthracycline and taxane chemotherapy; trastuzumab and pertuzumab throughout for HER2-positive disease; pembrolizumab-based chemotherapy for triple-negative disease by extrapolation from KEYNOTE-522.98

Other settings

SubgroupSettingApproachProducts and trialsEvidence
All comersSurgeryModified radical mastectomy with axillary dissection after response to chemotherapy; breast conservation, sentinel node biopsy alone and skin-sparing approaches are avoided, and reconstruction is deferred until after radiotherapy.-
All comersRadiotherapyPost-mastectomy radiotherapy to the chest wall and regional nodes in every patient, with bolus and often a higher dose for poor responders.93
HR-positiveAfter trimodality treatmentEndocrine therapy for hormone receptor-positive disease; trastuzumab emtansine or trastuzumab deruxtecan for residual HER2-positive disease (KATHERINE, DESTINY-Breast05); olaparib or capecitabine for residual triple-negative disease as in non-inflammatory cancer.97

Sequence and caution pairings

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.