Combined modality approach in treatment of inflammatory carcinoma of the breast — MD Anderson Cancer Center experience

Inflammatory carcinoma of the breast is the most lethal form of breast cancer and has a dismal prognosis. Most of the patients die of distant metastases with or without locoregional control within the first 2 years after diagnosis. At MD Anderson Hospital, since 1973, all patients with inflammatory carcinoma of the breast were prospectively treated with a combined modality approach in three sequential studies. All patients received 3 cycles of Fluorouracil, Doxorubicin, and Cyclophosphamide (FAC) before local therapy. In the first protocol (from 1973–1977), primary radiotherapy was the local treatment modality, and chemotherapy was continued for a total of 2 years. From 1978–1981 (Protocol II), mastectomy became the primary local treatment and FAC was reinstituted within 10–14 days after surgery. After completion of the FAC, consolidative radiotherapy was given. From 1982–1986 (Protocol III), Vincristine and Prednisone were added to the FAC regimen and doxorubicin was given by a continuous infusion (Table 1).