1992: Inflammatory breast carcinoma: an immunohistochemical study using monoclonal anti-pHER-2/neu, pS2, cathepsin, ER and PR.
Anticancer Res 1992 May-Jun;12(3):591-7, Charpin, C, et al.
“Immunocytochemical assays were performed on frozen sections of inflammatory breast carcinomas (n = 22) using the following monoclonal antibodies (MoAb): anti-pHER2/neu, cathepsin, pS2, ER, PR and MoAb Ki67. The distribution of these proteins, known as prognostic indicators, was evaluated with an image analysis system (SAMBA, Alcatel TITN, France). On standard HE stained paraffin sections, only about 50% of inflammatory breast tumors exhibited intradermal tumor cell emboli. All tumors were strongly pHER/2neu positive. All tumors also, but to a lesser degree, were cathepsin and ki67 positive. Conversely, less than 40% were faintly ER, PR and pS2 immunoreactive. The results correlated with the high degree of malignancy of inflammatory breast carcinomas. Therefore the immuno-detection of these markers in addition to standard histological techniques appears to be a useful tool to evaluate the degree of malignancy of breast carcinomas.“
1992: Inflammatory Breast Cancer: a review.
J Clin Oncol 1992 Jun;10(6):1014-24, Jaiyesimi IA, et al.
“The natural history of inflammatory breast cancer and the recent advances in its management were reviewed. DESIGN: The English medical literature from 1924 to 1990 was reviewed using the Cancerline and Medline retrieval systems, and through a manual review of bibliographies of identified articles. RESULTS: The majority of patients with inflammatory breast cancer treated only with local therapies died 18 to 24 months after diagnosis. A combined modality approach with chemotherapy, surgery, and radiation therapy has improved disease-free and overall survival rates for inflammatory breast cancer. Approximately 35% to 55% of patients treated with combined modality regimens remain disease-free and alive at 5 years. CONCLUSION: Induction combination chemotherapy administered with radiation therapy, mastectomy, both, or with additional chemotherapy favorably alters the natural history of inflammatory breast cancer. New drug combinations and high-dose chemotherapy with autologous bone marrow support are being evaluated to improve further patient survival.“
From the article: “Only 1% to 6% of all patients with breast cancer in the United States have inflammatory breast cancer, whereas in Tunisia up to 55% of breast cancer patients have inflammatory breast cancer.“
Note: This often-repeated statement is, unfortunately, not what was written in the 1980 Epidemiologic features of rapidly progressing breast cancer in Tunisia, which includes, “A form of breast cancer characterized by rapid disease progression, inflammation, and edema is found in approximately 55% of the breast cancer patients presenting at the Institute Salah Azaiz, Tunis (Tunisia).“
1992: Inflammatory breast cancer: CT evaluation.
Clin Imaging 1992 Jul-Sep;16(3):183-6, Mogavero GT, et al.
“Eleven patients with inflammatory breast carcinoma were examined by computed tomography (CT) prior to treatment with radiation and chemotherapy. Determination was made of skin thickening of the affected breast, presence of diffuse breast tumor infiltration or mass, calcification, adenopathy; and metastases. All affected breasts demonstrated increased skin thickness relative to the nonaffected breast, ranging from 0.7 cm-3 cm. Each could further be characterized as having diffuse infiltration of the breast tissue (5), a focal mass lesion (4), or a combination of mass with associated infiltration (2). Two of the breast masses showed diffuse calcification. Only one patient had disease confined to breast tissue at the time of study. Nine patients presented with adenopathy; 7 axillary, 3 internal mammary, 2 supraclavicular, and 1 hilar. Bilateral adenopathy was noted in two patients. Distant metastases to lung, bone, or stomach were observed in 7 of 11 patients. Distant metastases and degree of adenopathy was not related to skin thickness, degree of tumor infiltration, or presence of a defined mass. Inflammatory breast cancer presents with a spectrum of computed tomography appearances. Computed tomography aids in the assessment of local disease, adenopathy, and distant metastases.“
1992: Two distinct mechanisms alter p53 in breast cancer: mutation and nuclear exclusion.
Proc Natl Acad Sci U S A 1992 Aug 1;89(15):7262-6, Moll, UM, et al.
“Twenty-seven cases of inflammatory breast cancer were screened for the presence of the p53 protein by immunocytochemical methods using a monoclonal antibody directed against the p53 protein. Three groups were detected: 8 cases (30%) had high levels of p53 in the nucleus of the cancer cells; 9 cases (33%) had a complete lack of detectable staining; 10 cases (37%) showed a pattern of cytoplasmic staining with nuclear sparing. Nucleotide sequence analysis of p53 cDNAs derived from the samples with cytoplasmic staining revealed only wild-type p53 alleles in 6 out of 7 cases. An eighth case was determined to be wild type by a single-strand conformation polymorphism. In contrast, the samples containing nuclear p53 contained a variety of missense mutations and a nonsense mutation. The p53 cDNAs from 3 of the tumors that lacked detectable p53 staining were analyzed, and all 3 had wild-type nucleotide sequences. Interestingly, a case of normal lactating breast tissue also showed intense cytoplasmic staining for p53 with nuclear sparing. These data suggest that some breast cancers that contain the wild-type form of p53 protein may inactivate its tumor-suppressing activity by sequestering this protein in the cytoplasm, away from its site of action in the cell nucleus. The detection of cytoplasmic p53 in normal lactating breast tissue could suggest that this is the mechanism employed in specific physiological situations to permit transient cell proliferation. This observation could explain how some breast cancer tissues inactivate p53 function without mutation.“
1992: Inflammatory carcinoma of the breast.
Eur J Gynaecol Oncol 1992;13(1 Suppl):7-11, Bonnier, P, et al.
“Inflammatory breast carcinoma has to be defined by accurate clinical and pathological criteria. The prognosis is very poor and improvements made by chemotherapy are limited to the increase in the disease-free period and overall survival for a few months.“
1993: Inflammatory breast carcinoma (carcinoma erysipeloides): an easily overlooked diagnosis.
Br J Dermatol 1993 Sep;129(3):324-6, Finkel, LJ, et al.
“A 70-year-old woman developed erythema and induration of the right chest wall, and swelling of her right arm. The provisional diagnosis was deep venous thrombosis and/or cellulitis of the right arm. Skin biopsy showed a poorly differentiated adenocarcinoma within lymphatic vessels, and immunohistochemical staining revealed this to be of breast origin. Inflammatory carcinoma or carcinoma erysipeloides represents < 1% of all cases of breast carcinoma. Our case illustrates the importance of considering this entity in the differential diagnosis of unilateral chest wall erythema and induration.“
1993: Poor prognosis of p53 gene mutation and nuclear overexpression of p53 protein in inflammatory breast carcinoma.
J Natl Cancer Inst 1993 Nov 3;85(21):1765-7, Riou, G, et al., no abstract available
1993: Inflammatory Breast Cancer.
Bull Cancer 1993 Dec;80(12):1024-34, Chevallier B.
1994: Management of inflammatory breast cancer.
World J Surg 1994 Jan-Feb;18(1):87-92, Singletary, SE, et al.
“Inflammatory breast cancer (IBC) is a rare but often fatal disease. This review discusses the following conclusions: (1) The diagnosis of IBC is based on the clinical triad of erythema, ridging with peau d’orange, and rapid onset. The importance of histologic evidence of dermal lymphatic involvement is controversial. (2) Combining doxorubicin-containing chemotherapy with mastectomy or radiation therapy improves survival over that achieved with mastectomy or irradiation alone. (3) Mastectomy after induction chemotherapy may not improve survival or decrease locoregional recurrence rates, but the surgery does provide important prognostic information on treatment response and enables use of a lower radiation dose afterward, which results in reduced long-term complications. (4) The optimal number of cycles and dose intensity of chemotherapy for IBC remain undefined.“
1994: Inflammatory carcinoma of the breast: the immunological findings.
Minerva Chir 1994 Dec;49(12):1351-6, Sacco, R, et al.
“The authors discuss a case of inflammatory breast cancer, treated by interdisciplinary therapy (surgical, radiating immuno and chemo therapy). The immune status was evaluated by the determination of the lymphocytes population, monocytes and granulocytes. This evaluation was made before and after immunotherapy (i.e. subcutaneous administration of IL 2). IL 2 receptors were evaluated too. A daily dose of recombinant IL 2 (18 millions U.I.) was administered for six consecutive days. The follow-up studies showed a clear increase of total T lymphocytes, a normalization of T helper/inducers ratio, an improvement of T cytotoxic/suppressors ratio, an increased level of IL 2 receptors. The induction of mRNA for CM-CMF, G-CFS, IL 3, IL 5, IL 6, was also demonstrated, as well as a plasmatic increase of all the growth factors. A rise in neutrophils and eosinophils was documented. These results allowed the continuation of therapeutic approach with the complex radiation-chemotherapy program.“
