Survival benefit of surgery for inflammatory breast cancer patients.

Background: Inflammatory breast cancer (IBC) is considered as the most aggressive subtype of breast cancer. The purpose of this study is to evaluate the effect of surgical treatments on IBC patients.

Methods: Based on propensity score matching (PSM) analysis, we evaluated the prognostic significance of surgical intervention in patients with IBC by Cox proportional hazard models. A subgroup analysis was conducted to evaluate the impact of surgical treatment on patients of various groups. Kaplan-Meier (KM) analysis and log-rank tests were used to compare survival in the matched population.

Results: A total of 2,473 patients with IBC diagnosed between 2000 and 2020 were assessed from the Surveillance, Epidemiology, and End Results (SEER) database. There were 298 patients in the non-surgery group and 2,175 patients in the surgery group. In the multivariable Cox analysis, IBC patients treated by surgery showed higher overall survival (OS) rates [hazard ratio (HR) =0.50, 95% confidence interval (CI): 0.43-0.57, P<0.001]. After PSM, the multivariable Cox analysis revealed significant associations between age, race, node (N) status, estrogen receptor (ER) status, human epithelial growth factor receptor-2 (HER2) status, surgery, chemotherapy, and OS. Within the matched population analysis, patients derived significant benefits from surgery (HR =0.51, 95% CI: 0.42-0.62, P<0.001). Moreover, the OS outcomes of patients who received radiation therapy or chemotherapy in addition to surgical treatment were superior to those without surgery (chemotherapy, P<0.001; radiation therapy, P<0.001).

Conclusions: IBC patients who were treated with surgery had better OS outcomes. Therefore, a multimodality approach is recommended for the management of IBC, which involves the use of surgical intervention as the main treatment modality.