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There is ongoing discussion regarding the role of modified radical mastectomy (MRM) in patients with de novo stage IV inflammatory breast cancer (IBC). Terry Arnold, founder of The IBC Network Foundation reached out to Dr. Anthony Lucci, the leading IBC expert on surgery for IBC treatment. He replied with the following information: 

“In both papers there is mention that MRM- removal of breast and lymph nodes. We have the best outcomes with MRM and RT- not just with simple mastectomy. Unfortunately, as you are well aware, there is a move to de-escalate, even for IBC and without data to show it is safe. Thank you for trying to help increase awareness about this. We are submitting a paper to this year’s ASBRS showing that with MRM our long term f/u – median over 5 years- shows LRR rate of only around 6%- but that is if they got MRM to negative margins and then PMRT. This is the issue with de escalation- we do not know if those numbers would hold up with doing less, but the historical data says they would not, as historical LRR rates for IBC were around 20%.”

 

The two papers he suggested:
IBC consensus statement paper here: https://pubmed.ncbi.nlm.nih.gov/20603440/
The paper on improved outcomes for Stage IV IBC with MRM: https://pubmed.ncbi.nlm.nih.gov/33403525/
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