inflammatory breast cancer; mastitis carcinomatosa
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Epidemiology
- incidence of inflammatory breast cancer increases with age, peaking at ~65 years then stabilizes or decreases slightly
- most cases are diagnosed in women 40-59 years of age
- case of 33 year old woman[1]
- 3% of all breast cancers
Pathology
- aggressive, rapidly progressive cancer
- lymphatic obstruction due to invasive breast adenocarcinoma
- edema, inflammation
- dermal-lymphatic infiltration
- despite name, not associated with inflammatory infiltrate[3]
Clinical manifestations
- erythema, edema & thickening of the breast skin (may have the appearance of an orange peel, peau d'orange)
- pruritus, pain, tenderness, warmth
- involves at least one-third of the breast
- no fever
- nipple retraction can occur
- in most cases a distinct breast mass not felt
Diagnostic criteria
- based upon clinical appearance[1]
Laboratory
Diagnostic procedures
- breast biopsy of inflammed tissue
- presence of lymphatic emboli in a breast biopsy
Radiology
- not diagnostic, part of staging for breast cancer
- CT of abdomen & thorax
- bone scan[1]
Complications
- high risk for metastases[1]
- axillary vein thrombosis[1]
Differential diagnosis
Management
- neoadjuvant chemotherapy or endocrine therapy, mastectomy & adjuvant radiation therapy[1]
More general terms
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19. American College of Physicians, Philadelphia 2015, 2018, 2021.
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025 - ↑ Chia S, Swain SM, Byrd DR, Mankoff DA. Locally advanced and inflammatory breast cancer. J Clin Oncol. 2008 Feb 10;26(5):786-90 PMID: https://pubmed.ncbi.nlm.nih.gov/18258987
- ↑ 3.0 3.1 WHO Classification of Tumors of the Breast and Female Genital Organs. Editors: Tavassoli FA, Devilee P IARC Press, 2003
- ↑ NEJM Knowledge+ Question of the Week. Sept 11, 2018 https://knowledgeplus.nejm.org/question-of-week/945/
- ↑ Dushkin H, Cristofanilli M. Inflammatory breast cancer. J Natl Compr Canc Netw 2011 Feb 12; 9:233 PMID: https://pubmed.ncbi.nlm.nih.gov/21310844
- ↑ Jagsi R, Mason G, Overmoyer BA, et al; Susan G. Komen-IBCRF IBC Collaborative in partnership with the Milburn Foundation. Inflammatory breast cancer defined: proposed common diagnostic criteria to guide treatment and research. Breast Cancer Res Treat. 2022;192:235-43. PMID: https://pubmed.ncbi.nlm.nih.gov/34973083
- ↑ Hester RH, Hortobagyi GN, Lim B. Inflammatory breast cancer: early recognition and diagnosis is critical. Am J Obstet Gynecol. 2021 Oct;225(4):392-396. PMID: https://pubmed.ncbi.nlm.nih.gov/33845027 Review.