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Inflammatory breast cancer

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Overview

Inflammatory breast cancer[1] is an especially aggressive[2] type of breast cancer that can occur in women of any age (and, although extremely rarely, in men). It is unique because it often does not present with a lump and therefore often is not detected by mammography or ultrasound.[3] It presents with the signs and symptoms of a breast infection such as mastitis.

IBC or Inflammatory Breast Cancer causes breast changes in the nipple and surrounding areas. Other symptoms include rapid increase in breast size, redness, persistent itching, skin hot to the touch. IBC often initially resembles mastitis, and is sometimes misdiagnosed as an insect bite.

Inflammatory breast cancer is defined histologically by the presence of cancer cells in the subdermal lymphatics on skin biopsy. Diagnosis is done with an MRI or biopsy.



Differentiating Inflammatory Breast cancer from other Diseases

Inflammatory breast cancer must be differentiated from other diseases that cause breast pain and swelling as shown below:[4][5] [6][7][8][9][10][11][12][13]

Diseases Laboratory Findings Physical Examination History and Symptoms Other Findings
Breast milk culture Biopsy Breast tenderness Skin induration Cordlike vein appearance History of trauma Nipple retraction Nipple discharge Erythema Fever Warmth Lymphadenopathy Itching
Breast abscess + for bacteria ✘ βœ” βœ” ✘ βœ” ✘ βœ” βœ” βœ” βœ” ✘ ✘
Mastitis + for bacteria ✘ βœ” ✘ βœ” ✘ βœ” βœ” βœ” βœ” βœ” ✘
Inflammatory breast cancer ✘ βœ” βœ” βœ” ✘ βœ” ✘ βœ” ✘ βœ” βœ” βœ” *Peau d’ orange appearance of the skin

*Metastasis is common.

Galactocele ✘ ✘ ✘ ✘ ✘ ✘ βœ” ✘ ✘ ✘ ✘ ✘ It is differentiated from other masses by US.
Plugged duct ✘ ✘ βœ” ✘ ✘ ✘ ✘ ✘ ✘ ✘ ✘ ✘
Mondor’s syndrome βœ” βœ” βœ” ✘ Retracted breast skin and elevation of the skin may be observed.
Cellulitis ✘ βœ” βœ” βœ” ✘ βœ” βœ” ✘
Fibroadenoma ✘ βœ” ✘ ✘ ✘ ✘ βœ” *Peau d’ orange skin apperance.

*Enlarged veins on the skin

References

  1. ↑ “Inflammatory Breast Cancer: Questions and Answers”. National Cancer Institute. Retrieved 2006-12-02.
  2. ↑ “Inflammatory breast cancer”. Mayo Foundation for Medical Education and Research. Retrieved 2006-12-02.
  3. ↑ “Facts for Life – Inflammatory Breast Cancer” (PDF). Susan G. Komen for the Cure. Retrieved 2006-12-02.
  4. ↑ Greydanus DE, Matytsina L, Gains M (2006). “Breast disorders in children and adolescents”. Prim Care. 33 (2): 455–502. doi:10.1016/j.pop.2006.02.002. PMIDΒ 16713771.
  5. ↑ Jahanfar S, Ng CJ, Teng CL (2013). “Antibiotics for mastitis in breastfeeding women”. Cochrane Database Syst Rev (2): CD005458. doi:10.1002/14651858.CD005458.pub3. PMIDΒ 23450563.
  6. ↑ Lam E, Chan T, Wiseman SM (2014). “Breast abscess: evidence based management recommendations”. Expert Rev Anti Infect Ther. 12 (7): 753–62. doi:10.1586/14787210.2014.913982. PMIDΒ 24791941.
  7. ↑ Kleer CG, van Golen KL, Merajver SD (2000). “Molecular biology of breast cancer metastasis. Inflammatory breast cancer: clinical syndrome and molecular determinants”. Breast Cancer Res. 2 (6): 423–9. doi:10.1186/bcr89. PMCΒ 138665. PMIDΒ 11250736.
  8. ↑ Dawood S, Merajver SD, Viens P, Vermeulen PB, Swain SM, Buchholz TA; et al. (2011). “International expert panel on inflammatory breast cancer: consensus statement for standardized diagnosis and treatment”. Ann Oncol. 22 (3): 515–23. doi:10.1093/annonc/mdq345. PMCΒ 3105293. PMIDΒ 20603440.
  9. ↑ Jaiyesimi IA, Buzdar AU, Hortobagyi G (1992). “Inflammatory breast cancer: a review”. J Clin Oncol. 10 (6): 1014–24. doi:10.1200/JCO.1992.10.6.1014. PMIDΒ 1588366.
  10. ↑ Indelicato DJ, Grobmyer SR, Newlin H, Morris CG, Haigh LS, Copeland EM; et al. (2006). “Delayed breast cellulitis: an evolving complication of breast conservation”. Int J Radiat Oncol Biol Phys. 66 (5): 1339–46. doi:10.1016/j.ijrobp.2006.07.1388. PMIDΒ 17126205.
  11. ↑ Belleflamme M, Penaloza A, Thoma M, Hainaut P, Thys F (2012). “Mondor disease: a case report in ED”. Am J Emerg Med. 30 (7): 1325.e1–3. doi:10.1016/j.ajem.2011.06.031. PMIDΒ 21855258.
  12. ↑ Shetty MK, Watson AB (2001). “Mondor’s disease of the breast: sonographic and mammographic findings”. AJR Am J Roentgenol. 177 (4): 893–6. doi:10.2214/ajr.177.4.1770893. PMIDΒ 11566698.
  13. ↑ Kadioglu H, Yildiz S, Ersoy YE, YΓΌcel S, MΓΌslΓΌmanoğlu M (2013). “An unusual case caused by a common reason: Mondor’s disease by oral contraceptives”. Int J Surg Case Rep. 4 (10): 855–7. doi:10.1016/j.ijscr.2013.07.026. PMCΒ 3785854. PMIDΒ 23959419.

See also

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