J Cancer 2017; 8(10):1726-1732. doi:10.7150/jca.20095

Research Paper

Lack of Breastfeeding History in Parous Women with Inflammatory Breast Cancer Predicts Poor Disease-Free Survival

Shane R. Stecklein1, Jay P. Reddy1, Adam R. Wolfe1, Mirtha S. Lopez2, Tamer M. Fouad3,4, Bisrat G. Debeb1, Naoto T. Ueno3,5, Abenaa M. Brewster3,6, Wendy A. Woodward1,5✉

1. Department of Radiation Oncology
2. Department of Epidemiology
3. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
4. Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
5. Morgan Welch Inflammatory Breast Cancer Research Program and Clinic
6. Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America

Abstract

Purpose: Breastfeeding alters the breast microenvironment, and several lines of evidence suggest the breast microenvironment contributes to the clinical phenotype of inflammatory breast cancer. We investigated breastfeeding history as a modifier of locoregional recurrence (LRR), distant metastasis (DM), disease-free survival (DFS), and overall survival (OS) in parous women with inflammatory breast cancer.

Methods: Parous women with inflammatory breast cancer were identified from a prospective registry at The University of Texas MD Anderson Cancer Center. We compared patient and tumor characteristics, LRR, DM, DFS, and OS patients with (BF+) and without (BF-) a history of breastfeeding.

Results: Eighty-two patients were included. At a median follow-up of 50 months, BF+ patients had significantly lower risk of LRR (9.0% vs. 23.6%; p=0.01), a lower risk of DM (26.8% vs. 53.8%; p=0.008), and better DFS (73.1% vs. 48.1%; p=0.006) than BF- patients. On multivariate analysis, BF+ history was associated with significantly lower risk of DM (hazard ratio 0.38, 95% confidence interval 0.15-0.97; p=0.04) and better DFS (hazard ratio 0.37, 95% confidence interval 0.15-0.93; p=0.04) after adjusting for established predictive and prognostic variables. The prognostic significance of breastfeeding may be most pronounced in women with triple-negative IBC.

Conclusion: A lack of breastfeeding history in parous women with inflammatory breast cancer may predict worse prognosis. We speculate that breastfeeding-induced alterations in the breast microenvironment may alter the aggressiveness of inflammatory breast cancer.

Keywords: Inflammatory Breast Cancer, Breastfeeding, Microenvironment, Epidemiology

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How to cite this article:
Stecklein SR, Reddy JP, Wolfe AR, Lopez MS, Fouad TM, Debeb BG, Ueno NT, Brewster AM, Woodward WA. Lack of Breastfeeding History in Parous Women with Inflammatory Breast Cancer Predicts Poor Disease-Free Survival. J Cancer 2017; 8(10):1726-1732. doi:10.7150/jca.20095. Available from http://www.jcancer.org/v08p1726.htm