The effect of systemic chemotherapy on minimal residual disease in the blood and bone marrow of patients with inflammatory breast cancer

Abstract

Inflammatory breast cancer (IBC) is a particularly aggressive subtype of breast cancer that affects approximately 2.5% of patients with breast cancer in the industrialized countries, with a higher incidence reported in some other regions of the world [1–3]. Circulating tumour cells (CTCs) and disseminated tumor cells (DTCs) have become increasingly accepted as independent prognostic factors both in patients with primary and with metastatic breast cancer [8—12]. Several research groups have reported on the enumeration of CTCs and DTCs in patients with IBC [22-23, 27-29]. Although particularly data in metastatic IBC are limited, the probability of detecting CTCs and DTCs in untreated IBC seems higher than what has been reported in any other subgroup of patients with breast cancer. These observations are in line with the purported prognostic significance of CTCs and DTCs in breast cancer and the well-known aggressive clinical course of IBC. Furthermore, they provide a reasonable explanation for the necessity of chemotherapy in the management of these patients and lend support to the hypothesis that improvement in IBC can only arise from superior systemic agents.