Inflammatory Breast Cancer

Clinical Findings

  • skin erythema
  • edema (peau d'orange)
  • browny breast induration
  • warmth
  • asymmetric enlargement.

Extensive lymphovascular invasion by tumor emboli⇒involves the superficial dermal plexus of vessels in the papillary and high reticular dermis

It's important to distinguish inflammatory breast cancers vs LABC with secondary lymphatic congestion.

  • Neglected primary tumors can also lead to erythema, edema, warmth, and asymmetric enlargement, particularly when bulky axillary adenopathy impedes the normal lymphatic flow from the breast.
    • Inflammatory→ rapid onset, LABC→ long interval between the first symptom and the presentation for medical treatment.

  • 70% at presentation local dis.
  • Usually high grade and ER NEG, but HER2 same
  • Before chemo era → almost uniformly fatal
    • < 5% survived past 5 years
    • Median survival time for such patients was <15 months
    • Introduction of doxorubicin-based chemotherapy
      • Recent improve
      • Local control rates for patients treated with chemotherapy, mastectomy, and postmastectomy radiation now approach 70% to 80%, and 5-year survival rates are 30% to 40%