I read this sentence in a reputable publication a week ago: "Cancer's malignancy, a curse that invariably if not inevitably ends in death, infects the way patients are regarded, and how they regard themselves." I am OK on invariable meaning non-varying, and inevitable meaning it's definitely going to happen. I am fond of subtle nuances of meaning, but after a week I am still not sure that I see the point of "invariably if not inevitably" in this context. It seems to me that "inevitably" would have carried the meaning perfectly well on its own. What was the writer trying to say?