Inflammatory breast cancer (IBC) is considered the most aggressive form of breast cancer and carries a poor prognosis, even with modern advancements in breast cancer care overall. It is rare, often misdiagnosed, and an understudied disease entity. This qualitative review emphasizes IBC's clinical presentation, evolving diagnostic criteria, and current clinical management, including the standard trimodality approach for stage III management. IBC-specific clinical trials are lacking, but we highlight current and upcoming interventional trials with dedicated IBC populations, demonstrating the future directions of this field, transforming management and improving patient outcomes.
Purpose This work reports on the proof-of-concept testing for a suite of educational modules designed to improve oncology clinician sexual health (SH) communication with adolescent and young adult (AYA) patients. Methods Pediatric oncology clinicians completed four interactive SH education modules. Intervention feasibility was evaluated through rates of intervention completion and study retention, with benchmarks of 60% and 70%, respectively. Acceptability and perceived usefulness were assessed through standardized self-report measures, using a benchmark of 70% of participants rating the intervention favorably. Pre- and postsurveys evaluated knowledge, attitudes and beliefs, SH communication practices, and perceived self-efficacy. Open-ended feedback and key takeaways from each module were analyzed qualitatively. Results A total of 45 clinicians enrolled, with 39 completing the intervention and study surveys. Completion and retention rates (86.6% and 100%, respectively) exceeded the preset feasibility benchmarks. Positive endorsement of self-report measures demonstrated acceptability (100%) and perceived usefulness (94.9%). Pre- and postintervention surveys signaled increases in clinician knowledge, beliefs, and self-efficacy. Key qualitative insights from participants were received pertaining to AYA concerns, needs, and preferences and clinician responsibilities. Conclusion This innovative approach to clinician education on SH demonstrates potential to improve clinician knowledge and engagement in SH conversations with AYAs, a key first step in improving AYA SH during and after cancer. Next steps must focus on a larger trial to assess intervention effectiveness.
Purpose Perioperative 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) is a guideline-recommended standard for patients with resectable gastric cancer or gastroesophageal junction adenocarcinoma globally. Guidance is limited on patient selection, nutritional optimization, and toxicity management within existing guidelines. This study aimed to develop an international consensus to address these management gaps. Methods A modified Delphi methodology, informed by the RAND/UCLA Appropriateness Method, was conducted virtually between March and August 2025. A multidisciplinary panel of 16 experts independently rated draft clinical statements across multiple domains. Responses were anonymized, with structured, iterative rounds of feedback and re-rating. Consensus was defined a priori as a median score of 7-9 (appropriate) or 1-3 (inappropriate) with a disagreement index ≤1.0. Results Consensus was reached on 66.3% of the statements. Experts agreed that patients aged >70 years should not be routinely excluded from perioperative FLOT but require comprehensive assessment; inclusion of Eastern Cooperative Oncology Group performance status (ECOG PS) 0-1 is appropriate, and ECOG PS 0-2 may be considered on a case-by-case basis. Adequate organ function, correction of baseline conditions, hepatitis B screening, and dihydropyrimidine dehydrogenase testing are appropriate before FLOT initiation. Universal baseline nutritional screening and support, proactive intervention for malnourished patients, and structured physical activity were endorsed. Surgical planning was supported through multidisciplinary input, with defined perioperative windows, individualized dosing, and flexibility in pre-/postoperative cycles. For toxicity management, the panel supported dose modification over drug omission, where possible. Conclusion This Delphi consensus provides expert-driven, practice-oriented advisories codifying fitness-based selection, nutrition-forward optimization, and pragmatic toxicity management. The resulting guidance builds on current standards and provides internationally applicable consensus statements to ultimately enhance patient care.
