Top Line: Inflammatory breast cancer is biologically distinct from all other breast cancers with no proven effective de-esclation strategy.
The Study: A SEER analysis of stage III breast cancer treated 2010–2020 compared treatments trends and outcomes inflammatory (n=3,227) with non-inflammatory (n=44,475) breast cancer. As expected, inflammatory breast cancer carried significantly worse cancer-specific survival across all subtypes: HR+/HER2− (aHR 1.53), HR+/HER2+ (aHR 1.45), HR-/HER2+ (aHR 1.64), and triple-negative (aHR 1.69). Receipt of trimodality therapy including neoadjuvant systemic therapy followed by modified radical mastectomy and post-mastectomy radiation–aka the long-held standard–significantly improved cancer-specific survival for inflammatory disease (aHR 0.67). Unfortunately, use of trimodality therapy declined over the decade from 34% to 24%, driven by decreases in use of neoadjuvant therapy and de-escalations in surgery and nodal dissections. Meanwhile, survival further diverged over time, improving for non-inflammatory but not inflammatory cancers.
TBL: This study suggests surprisingly low rates of use of standard full-court press treatment for inflammatory breast cancer, despite its consistent association with longer survival outcomes, with notable recent year-over-year declines. | Leone, JAMA Netw Open 2026
The Study: A SEER analysis of stage III breast cancer treated 2010–2020 compared treatments trends and outcomes inflammatory (n=3,227) with non-inflammatory (n=44,475) breast cancer. As expected, inflammatory breast cancer carried significantly worse cancer-specific survival across all subtypes: HR+/HER2− (aHR 1.53), HR+/HER2+ (aHR 1.45), HR-/HER2+ (aHR 1.64), and triple-negative (aHR 1.69). Receipt of trimodality therapy including neoadjuvant systemic therapy followed by modified radical mastectomy and post-mastectomy radiation–aka the long-held standard–significantly improved cancer-specific survival for inflammatory disease (aHR 0.67). Unfortunately, use of trimodality therapy declined over the decade from 34% to 24%, driven by decreases in use of neoadjuvant therapy and de-escalations in surgery and nodal dissections. Meanwhile, survival further diverged over time, improving for non-inflammatory but not inflammatory cancers.
TBL: This study suggests surprisingly low rates of use of standard full-court press treatment for inflammatory breast cancer, despite its consistent association with longer survival outcomes, with notable recent year-over-year declines. | Leone, JAMA Netw Open 2026