{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T03:39:50Z","timestamp":1785728390043,"version":"3.56.0"},"reference-count":43,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T00:00:00Z","timestamp":1627603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Inflammatory breast cancer (IBC) is a clinical diagnosis. Here, we examined the association of a \u201cclassic\u201d triad of clinical signs, swollen involved breast, nipple change, and diffuse skin change, with overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Breast medical photographs from patients enrolled on a prospective IBC registry were scored by two independent reviewers as classic (triad above), not classic, and difficult to assign. Chi\u2010squared test, Fisher's exact test, and Wilcoxon rank\u2010sum test were used to assess differences between patient groups. Kaplan\u2013Meier estimates and the log\u2010rank test and Cox proportional hazard regression were used to assess the OS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analyzed 245 IBC patients with median age 54 (range 26\u201381), M0 versus M1\u00a0status (157 and 88 patients, respectively). The classic triad was significantly associated with smoking, post\u2010menopausal status, and metastatic disease at presentation (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002, 0.013, and 0.035, respectively). Ten\u2010year actuarial OS for not classic and difficult to assign were not significantly different and were grouped for further analyses. Ten\u2010year OS was 29.7% among patients with the classic sign triad versus 57.2% for non\u2010classic (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001). The multivariate Cox regression model adjusting for clinical staging (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.0001) and TNBC status (&lt;0.0001) demonstrated classic presentation score significantly associated with poorer OS time (HR 2.6, 95% CI 1.7\u20133.9, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A triad of classic IBC signs independently predicted OS in patients diagnosed with IBC. Further work is warranted to understand the biology related to clinical signs and further extend the understanding of physical examination findings in IBC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.4170","type":"journal-article","created":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T08:50:45Z","timestamp":1627635045000},"page":"6261-6272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Inflammatory breast cancer appearance at presentation is associated with overall survival"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5768-2378","authenticated-orcid":false,"given":"Wintana","family":"Balema","sequence":"first","affiliation":[{"name":"Graduate School of Biomedical Sciences The University of Texas Health Science Center at Houston Houston TX USA"},{"name":"Department of Radiation Oncology Morgan Welch IBC Clinic and Research Program The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randa","family":"El\u2010Zein","sequence":"additional","affiliation":[{"name":"Department of Radiology Houston Methodist Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bisrat G.","family":"Debeb","sequence":"additional","affiliation":[{"name":"Graduate School of Biomedical Sciences The University of Texas Health Science Center at Houston Houston TX USA"},{"name":"Department of Breast Medical Oncology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megumi","family":"Kai","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Morgan Welch IBC Clinic and Research Program The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Overmoyer","sequence":"additional","affiliation":[{"name":"Dana\u2010Farber Cancer Institute Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy D.","family":"Miller","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0356-498X","authenticated-orcid":false,"given":"Huong T.","family":"Le\u2010Petross","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Morgan Welch IBC Clinic and Research Program The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0166-7275","authenticated-orcid":false,"given":"Naoto T.","family":"Ueno","sequence":"additional","affiliation":[{"name":"Graduate School of Biomedical Sciences The University of Texas Health Science Center at Houston Houston TX USA"},{"name":"Department of Breast Medical Oncology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7935-739X","authenticated-orcid":false,"given":"Wendy A.","family":"Woodward","sequence":"additional","affiliation":[{"name":"Graduate School of Biomedical Sciences The University of Texas Health Science Center at Houston Houston TX USA"},{"name":"Department of Radiation Oncology Morgan Welch IBC Clinic and Research Program The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41568-018-0010-y"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji172"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00146-1"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","unstructured":"MasonG OvermoyerB WoodwardW et al. 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