M. D. Anderson Establishes Clinic, Research Program for Inflammatory Breast Cancer

First center in world dedicated to treatment, research of the rare disease

10/20/06 - In an effort to best understand the complexities of a very rare, aggressive and often lethal form of breast cancer, and to improve the outcome of women everywhere with the disease, The University of Texas M. D. Anderson Cancer has announced today (Oct. 20) the first clinic in the world dedicated to the treatment and research of inflammatory breast cancer (IBC).

Under the co-direction of Massimo Cristofanilli, M.D., associate professor in the Department of Breast Medical Oncology, and Thomas Buchholz, M.D., professor in the Department of Radiation Oncology, the clinic will be housed in M. D. Anderson’s Nellie B. Connally Breast Center. The clinic will open to patients Oct. 25.

“Our primary goal of both the clinic and the research program is to finally understand why this disease is different, why it is so resistant to treatment, and ultimately to develop therapies that improve the well-being of women with this very rare form of breast cancer,” says Cristofanilli.

“The opening of the center provides a unique opportunity for patients with IBC to receive state-of-the-art treatment from a dedicated team of experienced professionals, while also contributing to the understanding of this disease through participating in protocol-based research,” adds Buchholz.

IBC is rare - representing just 1-2 percent of all breast cancers diagnosed. Unlike other breast cancers that present as a lump, IBC’s symptoms are unique and include: redness, swelling, and warmth in the breast, skin that is reddish, purple or bruised, has ridges and/or appears pitted like an orange. Other symptoms can include burning, aching or tenderness, an increase in breast size, and/or an inverted nipple.

A fast growing and extremely aggressive cancer, women with IBC are more likely than other women with breast cancer to be misdiagnosed, and ultimately diagnosed after the disease has metastasized, says Cristofanilli.

Already, M. D. Anderson sees approximately 30 new cases of IBC a year - more than any other institution in this country, says Cristofanilli. With the new clinic, Cristofanilli and his team hope to see 60-80 new cases annually.

“The scientific community needs a comprehensive clinic and research program in order to make significant progress in the overall prognosis of women with IBC. There are so few cases of this disease and they are scattered throughout the world. With our efforts, we will collect appropriate serum and tissue, look at gene expression and gather other pertinent biological information, in hopes of finally developing treatment guidelines for IBC,” he continues.

According to Cristofanilli, 40 percent of women with IBC will survive five years.

“There are a number of reasons for such a disappointing survival outcome - a delay in diagnosis because it is often mistaken for a rash, the lack of expertise in treating IBC because it is so rare, and the relative resistance the disease has to standard chemotherapeutic agents,” he says.

“Treating IBC in an environment where all subspecialties involved in breast cancer management are optimally coordinated is a very important determinant of a successful outcome,” adds Buchholz.

For women with IBC, finding a medical team experienced in treating the rare disease is paramount, says Cristofanilli, because all aspects of treating IBC - including staging, diagnosis and therapy - are vastly different from other breast cancers.

“Because IBC usually does not occur in the form of a lump (rather the cancer spreads throughout the breast tissue), it is very difficult to detect the disease with a mammogram. Though still under study, we have found that with Postitron Emission Tomography (PET) scans, we can see more of the IBC disease, including lymph nodes far from the breast, which will allow us to determine if there is metastatic disease at the time of diagnosis,” he says.

Exploring new treatments for IBC will be a priority of the clinic, says Cristofanilli. Current treatment for IBC includes chemotherapy, surgery, radiation, targeted therapy and/or hormonal therapy when appropriate. In early preliminary studies, the hormonal therapy Tykerb (lapatinib) has shown promise for IBC patients whose tumors express the HER-2 gene.

“While much more work needs to be done, there is hope that this drug may help further improve the outcome of IBC patients. We hope to conduct future lapatinib studies in this clinic, and determine if the drug works by itself, with chemotherapy, or with several chemotherapies,” Cristofanilli says.

Along with Cristofnalli, the clinic will be staffed with a multidisciplinary team experienced in caring for women with IBC. Faculty include: Thomas Buchholz, M.D., professor, Department of Radiation Oncology and the center’s co-director; Anthony Lucci, M.D., associate professor, Department of Surgical Oncology; Gildy Babiera, M.D., assistant professor, Department of Surgical Oncology, Shaheena Dawood, M.D., Susan G. Komen Interdisciplinary Breast Fellow.

For more information about IBC, visit www.mdanderson.org. IBC patients interested in scheduling an appointment in the clinic should call M. D. Anderson’s Information Line, 1-800-392-1611, option 3.

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