Info
inflammatory breast cancer
Definition: a rare form of advanced, aggressive invasive carcinoma characterized by dermal lymphatic invasion of tumor cells
Clinical features
- Peau d’orange
- Erythematous, warm, and edematous skin plaques with prominent hair follicles that resemble orange peel
- Caused by obstruction of the lymphatic channels due to tumor growth
- Tenderness, burning sensation
- Blood-tinged nipple discharge
- Signs of metastatic disease (e.g., axillary lymphadenopathy) [16]
- Usually no palpable mass
Diagnostics: based on clinical features and biopsy [17]
- Diagnostic criteria (all must be met)
- Rapid onset of breast erythema, edema, warmth, and peau d’orange, with or without palpable mass on breast examination
- Erythema involving at least one-third of the breast
- Symptoms have been present for < 6 months
- Core needle biopsy confirming the presence of invasive carcinoma
- Skin punch biopsy: patients who meet the diagnostic criteria should undergo at least two full-thickness skin punch biopsies
- Further testing
- Imaging: bilateral mammogram and ultrasound of regional lymph node
- Receptor and HER2 gene testing
Differential diagnosis
- Mastitis
- Paget disease of the breast
- Breast abscess
Treatment
- chemotherapy (possibly in combination with targeted therapy) PLUS radiation PLUS modified radical mastectomy
- Prognosis: 5-year survival rate is ∼ 40%.