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Master Thesis

Cancer du sein inflammatoire non métastatique : à propos d’une série rétrospective de 140 patientes traitées à l’Institut Bergonié entre 1989 et 2010

Abstract : Introduction: Inflammatory breast cancer (IBC) is a rare disease of poor prognosis but whose incidence is steadily increasing. The management of IBC is linked to two main issues: locoregional and metastatic control. Studies on the subject are mostly retrospective and low workforce. The objective of this study is to evaluate the impact of mastectomy on patient survival, and secondarily to identify potential prognostic factors. Materials and methods: This is a monocentric retrospective study. The population included in the study included patients aged under 70 years treated at the institute from 1989 to 2010 for a unilateral breast cancer inflammatory ranked cT4dNxMo who received neoadjuvant chemotherapy (NAC). We divided the population into two treatment groups: the group "mastectomy" and "no mastectomy" group and four subgroups: the mastectomy group + adjuvant radiotherapy (MCA + RTH), neoadjuvant radiotherapy + mastectomy (RTH + MCA), radiotherapy alone (exclusive WHR) and partial mastectomy + adjuvant radiotherapy group (MP + RTH). We evaluated four criteria for these treatment groups: overall survival (OS), relapse-free survival (SSR), the metastasis-free survival (DFS) and local control (LC). Secondarily we researched the existence of prognostic factors can interact on these parameters. Results: The population analyzed included 140 patients aged on average 51 years. We observed a significant difference in 5 years on the CL (76.3% vs 61.1% p = 0.03) in favor of "mastectomy" group. The differences in favor of the group "mastectomy" on the SG (47.3% vs 39.8% p = 0.2), SSR (36.3% vs 25.2% p = 0.1), and SSM (36.9% vs 28.2% p = 0.3) n 'they were not significant. After analyzing the four subgroups, we observed an improvement in overall survival (74.0%, p = 0.02) and disease-free survival (54.8% p = 0.01) for the MCA group RTH + compared to other groups. The response to neoadjuvant chemotherapy was a prognostic factor for the 4 criteria. The initial clinical nodal status and presence of hormonal receptors affected the SSR, the SSM and the CL but not on the SG. Tumor grade influenced only on local control. Conclusion: Mastectomy in the tri-modal treatment of IBC appears to be justified. Prospective studies with larger workforce seem difficult to achieve given the scarcity of the pathology but confirm this impression.
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Master Thesis
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Submitted on : Tuesday, October 6, 2015 - 3:24:21 PM
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Adèle Dessaint. Cancer du sein inflammatoire non métastatique : à propos d’une série rétrospective de 140 patientes traitées à l’Institut Bergonié entre 1989 et 2010. Médecine humaine et pathologie. 2015. ⟨dumas-01212384⟩

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