Investigators may have uncovered the proportion of patients with inflammatory breast cancer who receive guideline-concordant care, according to a recent study published by Tadros et al in JAMA Network Open.
Background
Clinical practice guidelines currently recommend neoadjuvant systemic therapy followed by modified radical mastectomy without immediate reconstruction and postoperative radiation therapy as the preferred treatment approach in patients with inflammatory breast cancer.
Study Methods and Results
In this study, the investigators used data from the National Cancer Database to determine the rate of guideline-concordant care within 60 days of diagnosis among 6,945 patients with inflammatory breast cancer. Major outcome measures of the study included the correlations between patient, disease, treatment, and facility factors and the receipt of guideline-concordant care.
Overall, a total of 25.1% of the patients received complete guideline-concordant care, and 51.3% of them underwent the recommended surgical treatment. The investigators revealed that receipt of guideline-concordant care was associated with significantly improved overall survival. Black patients who did not receive guideline-concordant care had poorer overall survival than did White patients.
Conclusions
The investigators emphasized that efforts to improve the rates of provision of guideline-concordant care could improve survival outcomes, especially among racial minority patients.
In an accompanying editorial published in JAMA Network Open, Wendy A. Woodward, MD, PhD, of The University of Texas MD Anderson Cancer Center, noted that the data suggested de-escalation of treatment approaches for inflammatory breast cancer as well as a lack of awareness of guideline recommendations may have contributed to the low rate of guideline-concordant care.
Further studies exploring the factors influencing physician decision-making may be needed to better understand the low rate of guideline-concordant care among patients with inflammatory breast cancer.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
