#106 The challenges of setting up an inflammatory breast cancer registry. The george washington university experience.

摘要

PURPOSE: To determine the adequacy of current methods to identify patients with inflammatory breast cancer [IBC].METHODS: Characterization of IBC patients identified at The George Washington University Medical Center [GWUMC] between 1996-2001 was first initiated by identifying all patients identified as having IBC by the GWUMC Cancer Registry. Charts of all T3 and T4 breast cancer patients seen at GWUMC for the same period were reviewed retrospectively. These included all cases that would have been classified as EOD (Extent of Disease)-50 and 70 under the Surveillance, Epidemiology and End Results [SEER] system which is not in use at GWUMC. Using the abstracted data, decisions were made on whether a case fulfilled the criteria for IBC on the basis of clinical presentation, pathologic presentation, or both. Where historical histo-pathology blocks or slides were available, one pathologist reviewed for the presence or absence of dermal lymphatic invasion and/or lymphovascular invasion.RESULTS: The 19 cases recorded as IBC by the GWUMC Cancer Registry were confirmed by our review. These 19 either had classic clinical features of redness, warmth and edema, or the pathological features of dermal lymphatic invasion, or both. However we found an additional 8 cases among the 95 T3 and T4 patients that also fulfilled the criteria for IBC.CONCLUSION: This study suggests an under-reporting of cases of IBC at our University hospital, which subsequently may have contributed to under-reporting to the District of Columbia Central Cancer registry. The difficulties of case identification underlines the need for a uniform characterization of IBC as an entity. The identification of 27 IBC patients in our breast cancer population of 1055 (2.56%) is within the 2-6% range generally accepted for this entity.