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Inflammatory breast cancer: Clinical features and treatment

INTRODUCTION

Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer. It is characterized by the inflammatory appearance of the breast, ie, diffuse erythema and edema (picture 1 and picture 2). It can be confused with noninflammatory locally advanced breast cancer.

The epidemiology, clinical features, treatment, and prognosis of IBC will be reviewed here. Locally advanced breast cancer and the pathology and molecular pathogenesis of IBC are presented separately.

DEFINITION

The 2010 American Joint Committee on Cancer and the International Union for Cancer Control (AJCC-UICC) TNM breast cancer staging system defines inflammatory breast cancer (IBC) as a clinical-pathologic entity characterized by diffuse erythema and edema (peau d'orange) involving one-third or more of the skin of the breast (table 1) [1]. These "inflammatory" skin changes are caused by tumor emboli within the dermal lymphatics, not by infiltration of inflammatory cells. The diagnosis is based upon the clinical presentation. Although dermal lymphatic involvement supports the diagnosis of IBC, it is neither necessary nor sufficient in the absence of classical clinical findings. (See "Inflammatory breast cancer: Pathology and molecular pathogenesis".)

Not all skin changes qualify as IBC or even locally advanced breast cancer (LABC). IBC, as described above, is designated as primary tumor stage T4d. Tumor presentation with ulceration and/or ipsilateral satellite skin nodules and/or edema are T4b. Invasion of the dermis alone, such as dimpling of the skin or nipple retraction, does not qualify as T4 and may occur in T1, T2, or T3 without changing the classification.

                

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Literature review current through: 20.6: May 2012
This topic last updated: May 5, 2011
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