Few Patients Receive Complete Guideline-Concordant Care for Inflammatory Breast Cancer

Tadros A, Diskin B, Sevilimedu V, et al. Trends in Guideline-Concordant Care for Inflammatory Breast Cancer. JAMA Netw Open. 2025;8(2):e2454506.

Woodward WA. Deescalation Perils in Inflammatory Breast Cancer. JAMA Netw Open. 2025;8(2):e2454513.

Clinical practice guidelines recommend neoadjuvant systemic therapy followed by modified radical mastectomy without immediate reconstruction and postoperative radiation therapy as the preferred treatment approach for patients with inflammatory breast cancer. This study used data from the National Cancer Database (n = 6,945) to determine the rate of guideline concordant care within 60 days of diagnosis.

Associations of patient, disease, treatment, and facility factors with receipt of guideline concordant care were major outcome measures. Overall, only 25.1% of patients received complete guideline concordant care. The recommended surgical treatment was used in 51.3% of patients.

The data showed that receipt of guideline concordant care was associated with significantly improved overall survival. Black patients who did not receive guideline concordant care had significantly lower overall survival compared white patients.

The authors concluded that efforts to increase rates of provision of guideline-concordant care could improve survival outcomes, especially for racial minority patients.

In the editorial that accompanied the article, Woodward noted that these data suggest that de-escalation of treatment approaches for inflammatory breast cancer may be a reason for the low rate of guideline concordant care; a lack of awareness of guideline recommendations could be an explanation, as well. Additional information on reasons for clinician decisions is needed.