Update on the Management of Inflammatory
MASSIMO CRISTOFANILLI, AMAN U. BUZDAR, GABRIEL N. HORTOBÁGYI
Department of Breast Medical Oncology, The University of Texas M.D. Anderson Cancer Center,
Houston, Texas, USA
Key Words. Inflammatory breast cancer · Targeted therapies
Inflammatory breast cancer (IBC) is the most aggres-
sive manifestation of primary breast carcinoma, with the
clinical and biological characteristics of a rapidly prolifer-
ating disease. The multidisciplinary management of IBC
has changed in the past 3 decades and is presently clearly
outlined in sequence, with preoperative or neoadjuvant
chemotherapy representing the mainstay of treatment.
Anthracyclines and taxanes are the most effective cyto-
toxic agents in the management of primary breast cancer
and should be the standard of treatment for women with
IBC. Locoregional treatment includes radiotherapy with
or without surgery and continues to play a major role
after appropriate medical treatment. The many investi-
gations into the particular molecular determinants of IBC
development have provided several interesting new ther-
apeutic targets. Combination regimens that include
angiogenic modulators, farnesyl transferase inhibitors,
and p53 modulators hold great promise in the medical
management of IBC. Future therapeutic approaches
should focus on these discoveries so that we can improve
the overall prognosis for women with IBC. The Oncologist
The Oncologist 2003;8:141-148
Correspondence: Massimo Cristofanilli, M.D., Department of Breast Medical Oncology, The University of Texas M.D.
Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 424, Houston, Texas 77030, USA. Telephone: 713-792-2817;
Fax: 713-794-4385; e-mail: email@example.com Received November 27, 2002; accepted for publication January
8, 2003. ©AlphaMed Press 1083-7159/2003/$12.00/0
Inflammatory breast carcinoma (IBC) is the most
aggressive manifestation of primary breast carcinoma. It is
relatively rare, with an incidence of only 1%-6% in the
U.S. . African Americans have a higher incidence of
IBC than do Caucasians and other ethnic groups (10.1%,
6.2%, and 5.1%, respectively). Furthermore, a review of
the Surveillance, Epidemiology, and End Results (SEER)
program data comparing trends and patterns for breast
cancer between 1975-1977 and 1990-1992 revealed that
the incidence of IBC increased from 0.3 to 0.7 cases per
100,000 person-years, a much larger increase than that
observed for noninflammatory forms of breast cancer during
the same period. .
After completing this course, the reader will be able to:
1. Recognize the differences in biology and clinical outcome of IBC compared with non-IBC.
2. Summarize the standard of care for IBC.
3. Identify molecular targets and novel agents for future treatments of IBC.
Access and take the CME test online and receive one hour of AMA PRA category 1 credit at CME.TheOncologist.com
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Cristofanilli, Buzdar, Hortobágyi
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