Role of endocrine responsiveness and HER2/neu overexpression in inflammatory breast cancer treated with multimodality preoperative therapy

Claudia D'Alessandro, Silvia Dellapasqua, Laura Orlando, Luigi Santoro, Patrick Maisonneuve, Rosalba Torrisi, Alessandra Balduzzi, Eloise Scarano, Raffaella Ghisini, Giulia Peruzzotti, Aron Goldhirsch, Marco Colleoni

Research output: Contribution to journalArticle

Abstract

We analyzed the role of endocrine responsiveness and HER2/neu overexpression in inflammatory breast cancer treated with multimodality preoperative therapy. Thirty-eight patients (estrogen receptor [ER] and/or progesterone receptor [PgR] ≥10% of the cells 21, premenopausal 14, Ki-67 expression ≥20% of the cells 30, HER2/neu overexpressed 11) were treated with six courses of epirubicin, cisplatin and fluorouracil (FU) as continuous infusion, perioperative FU as continuous infusion, mastectomy and loco-regional radiotherapy. In endocrine-responsive patients, endocrine treatment (letrozole, either alone or if premenopausal with triptorelin) was given preoperatively and as adjuvant treatment. There were 32 objective responders (84.2%; 95% CI 70.0-94.6%), three of whom had pathologic complete remission. At the multivariate analysis disease-free survival was significantly worse in patients with ER and PgR absent tumors compared with the positive expression cohort (hazards ratio [HR]: 5.91; 95% CI 1.69-20.7; p = 0.005), in particular if HER2/neu overexpression was detected (HR: 16.5; 95% CI 4.24-64.5; p <0.0001). New multimodality and targeted strategies should be explored in endocrine nonresponsive breast cancer.

Original languageEnglish
Pages (from-to)435-441
Number of pages7
JournalBreast Journal
Volume14
Issue number5
DOIs
Publication statusPublished - Sep 2008

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Keywords

  • Inflammatory breast cancer
  • Nonendocrine responsive breast cancer
  • Preoperative therapy

ASJC Scopus subject areas

  • Internal Medicine
  • Oncology

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