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Abstract：
BACKGROUND: Inflammatory breast cancer (IBC) is a clinical diagnosis. Here, we examined the association of a \"classic\" triad of clinical signs, swollen involved breast, nipple change, and diffuse skin change, with overall survival (OS).
METHODS: Breast medical photographs from patients enrolled on a prospective IBC registry were scored by two independent reviewers as classic (triad above), not classic, and difficult to assign. Chi-squared test, Fisher\'s exact test, and Wilcoxon rank-sum test were used to assess differences between patient groups. Kaplan-Meier estimates and the log-rank test and Cox proportional hazard regression were used to assess the OS.
RESULTS: We analyzed 245 IBC patients with median age 54 (range 26-81), M0 versus M1 status (157 and 88 patients, respectively). The classic triad was significantly associated with smoking, post-menopausal status, and metastatic disease at presentation (p = 0.002, 0.013, and 0.035, respectively). Ten-year actuarial OS for not classic and difficult to assign were not significantly different and were grouped for further analyses. Ten-year OS was 29.7% among patients with the classic sign triad versus 57.2% for non-classic (p < 0.0001). The multivariate Cox regression model adjusting for clinical staging (p < 0.0001) and TNBC status (<0.0001) demonstrated classic presentation score significantly associated with poorer OS time (HR 2.6, 95% CI 1.7-3.9, p < 0.0001).
CONCLUSIONS: A triad of classic IBC signs independently predicted OS in patients diagnosed with IBC. Further work is warranted to understand the biology related to clinical signs and further extend the understanding of physical examination findings in IBC.
METHODS: Breast medical photographs from patients enrolled on a prospective IBC registry were scored by two independent reviewers as classic (triad above), not classic, and difficult to assign. Chi-squared test, Fisher\'s exact test, and Wilcoxon rank-sum test were used to assess differences between patient groups. Kaplan-Meier estimates and the log-rank test and Cox proportional hazard regression were used to assess the OS.
RESULTS: We analyzed 245 IBC patients with median age 54 (range 26-81), M0 versus M1 status (157 and 88 patients, respectively). The classic triad was significantly associated with smoking, post-menopausal status, and metastatic disease at presentation (p = 0.002, 0.013, and 0.035, respectively). Ten-year actuarial OS for not classic and difficult to assign were not significantly different and were grouped for further analyses. Ten-year OS was 29.7% among patients with the classic sign triad versus 57.2% for non-classic (p < 0.0001). The multivariate Cox regression model adjusting for clinical staging (p < 0.0001) and TNBC status (<0.0001) demonstrated classic presentation score significantly associated with poorer OS time (HR 2.6, 95% CI 1.7-3.9, p < 0.0001).
CONCLUSIONS: A triad of classic IBC signs independently predicted OS in patients diagnosed with IBC. Further work is warranted to understand the biology related to clinical signs and further extend the understanding of physical examination findings in IBC.
摘要：
背景：炎性乳腺癌（IBC）是一种临床诊断。这里,我们检查了临床体征的“经典”三联征的关联，受累乳房肿胀，乳头变化,和弥漫性皮肤变化，总生存期（OS）。
方法：来自前瞻性IBC登记的患者的乳房医学照片由两名独立评审员评分为经典（以上三联征），不经典,很难分配。卡方检验,费希尔的精确检验，和Wilcoxon秩和检验用于评估患者组之间的差异。使用Kaplan-Meier估计和对数秩检验和Cox比例风险回归来评估OS。
结果：我们分析了245例中位年龄54（范围26-81）的IBC患者，M0与M1状态（157和88例患者，分别)。经典三合会与吸烟密切相关，绝经后状态，和转移性疾病（分别为p=0.002、0.013和0.035）。非经典且难以分配的十年精算操作系统没有显着差异，并分组进行进一步分析。经典症状三联症患者的十年OS为29.7％，非经典症状为57.2％（p<0.0001）。校正临床分期(p<0.0001)和TNBC状态(<0.0001)的多变量Cox回归模型显示经典表现评分与较差的OS时间显著相关(HR2.6,95%CI1.7-3.9,p<0.0001)。
结论：在诊断为IBC的患者中，经典IBC体征的三联征独立地预测OS。需要进一步的工作来了解与临床体征相关的生物学，并进一步扩展对IBC中体格检查结果的理解。
方法：来自前瞻性IBC登记的患者的乳房医学照片由两名独立评审员评分为经典（以上三联征），不经典,很难分配。卡方检验,费希尔的精确检验，和Wilcoxon秩和检验用于评估患者组之间的差异。使用Kaplan-Meier估计和对数秩检验和Cox比例风险回归来评估OS。
结果：我们分析了245例中位年龄54（范围26-81）的IBC患者，M0与M1状态（157和88例患者，分别)。经典三合会与吸烟密切相关，绝经后状态，和转移性疾病（分别为p=0.002、0.013和0.035）。非经典且难以分配的十年精算操作系统没有显着差异，并分组进行进一步分析。经典症状三联症患者的十年OS为29.7％，非经典症状为57.2％（p<0.0001）。校正临床分期(p<0.0001)和TNBC状态(<0.0001)的多变量Cox回归模型显示经典表现评分与较差的OS时间显著相关(HR2.6,95%CI1.7-3.9,p<0.0001)。
结论：在诊断为IBC的患者中，经典IBC体征的三联征独立地预测OS。需要进一步的工作来了解与临床体征相关的生物学，并进一步扩展对IBC中体格检查结果的理解。
