Abstract PS2-01-25: Does surgery in a specialized clinic improve locoregional recurrence rates in Inflammatory Breast Cancer?

Abstract Background: Our institution has a specialized Inflammatory Breast Cancer (IBC) clinic (SIBCC) where almost all patients undergo trimodality therapy. Surgical management for IBC at SIBCC routinely consists of modified radical mastectomy to negative margins along with an axillary lymph node dissection after completion of neoadjuvant systemic therapy. We sought to evaluate the differences in surgical outcomes between patients who underwent surgery at SIBCC versus patients who underwent surgery at outside institutions (OSI). Methods: A retrospective analysis was performed on patients with IBC enrolled in a prospective registry from 2003-2025 at SIBCC. All patients underwent surgery for primary tumor removal either at SIBCC or an outside institution. Chi-squared test and Kaplan-Meier method were used for statistical analysis. Results: Of the 920 patients included, 620 had their surgical procedures completed at SIBCC, while 300 had surgery at OSI. Patients underwent the following surgical procedures: modified radical mastectomy (SIBCC: 620, 100%; OSI: 249, 83%), total mastectomy (SBICC: 0; OSI: 35, 11.7%), skin sparing mastectomy (SIBCC: 0; OSI: 5, 1.7%), and segmental mastectomy (SIBCC: 0; OSI: 5, 1.7%). Axillary lymph node dissections were performed in 96% of cases at SIBCC and 83% of cases at OSI. Pathologic nodal positivity was higher in the OSI group (40%) compared to the SIBCC group (31% p=0.021). Patients treated at outside institutions were significantly more likely to have positive surgical margins (63.2%) compared to those treated at SIBCC (2.5%, P0.001). Median number of lymph nodes removed was higher at SIBCC (20 vs 11) (p0.001). Of the 620 patients who completed surgery at SIBCC, 40% had a recurrence or progression, while 72% of surgical cases completed outside (216/300) had a recurrence or progression. Median overall survival was significantly longer among patients treated at SIBCC compared to those treated at OSI (153 vs 56 months, 95% CI: 141.2-164.8 vs 48.5-63.5). Similarly, patients treated at SIBCC had significantly improved relapse-free survival compared to those treated OSI (median RFS: 108 vs 16 months; p 0.001). Locoregional recurrence-free survival was significantly longer in patients treated at SIBCC compared to those treated at OSI (mean 185.8 months vs. 92.0 months, p0.001), highlighting the critical role of specialized surgical care in improving local disease control in IBC. Conclusion: Patients with inflammatory breast cancer had better outcomes when their surgery was performed at a specialized IBC clinic. This study demonstrated that a specialized surgical approach is associated with significantly lower rates of positive margins and improved locoregional recurrence-free survival. Citation Format: V. N. Sarli, S. Meas, M. Kai, M. Desai, N. Erry, S. X. Sun, H. M. Johnson, W. A. Woodward, A. Lucci. Does surgery in a specialized clinic improve locoregional recurrence rates in Inflammatory Breast Cancer? abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS2-01-25.