Incidence of inflammatory breast cancer in patients with clinical inflammatory breast symptoms

Abstract

BackgroundTo describe a large cohort of women with non-puerperal inflammatory breast and to identify characteristics of inflammatory breast cancer.MethodsAll patients consulting for inflammatory breast syndrome in the breast unit of our tertiary University hospital between September 2013 and December 2015 were prospectively included. We excluded women who were pregnant or in the postpartum period. Patients underwent systematic clinical examination and imaging (breast ultrasonography and mammography). A biopsy was performed if the clinician suspected a malignant lesion of the breast. Clinicopathologic and radiologic data were registered. Statistics were performed using R (3.0.2 version) software.ResultsAmong the 76 patients screened and included, 38 (50%) had a malignant lesion at final diagnosis, 21 (27.6%) were diagnosed with infectious disease and 17 (22.4%) with inflammatory disease of the breast. When compared to patients with benign disease, patients with a malignant lesion were significantly older (p = 0.022, CI95% 1.78–14.7), had a significantly bigger palpable mass (p<0.001, CI 95% 22.8–58.9), were more likely to have skin thickening (p = 0.05) and had more suspicious lymph nodes at clinical examination (p<0.001, CI 95% 2.72–65.3). Precise limits on ultrasonography were significantly associated with benign lesions. The presence of a mass (p = 0.04), micro calcifications (p = 0.04) or of focal asymmetry (p<0.001, CI95% 1.3–618) on mammography was significantly associated with malignant disease.ConclusionInflammatory breast cancer was common in our cohort of women consulting for inflammatory breast syndrome. Identifying these patients with high-risk malignancy is crucial in the management of an inflammatory breast.

Clinico-pathologic and mammographic characteristics of inflammatory and non-inflammatory breast cancer at six centers in North Africa

“…In our study, a larger percentage of IBC cases reported a discrete mass, inverted nipple, warmth and pain, and a slightly smaller percentage reported itching compared to a U.S. study (24). However, the percentage of IBC cases reporting pain and skin thickening in our study was similar to that in a French study (16). Significant erythema of the skin was the most frequent initial symptom reported by cases in the U.S.…”

“…Here we describe the clinico-pathologic and mammographic characteristics of the IBC and non-IBC cases included in this study, expanding upon previous studies (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). We also evaluate cases by photographic review and adherence to the two most recent definitions of IBC: the international expert panel consensus statement for standardized diagnosis (7) and the American Joint Committee on Cancer (AJCC) 8 th edition definition, which expands on the 7 th edition definition (which we used in our study) by considering duration history of symptoms/signs (2).…”

Vasculogenic mimicry-associated ultrastructural findings in human and canine inflammatory breast cancer cell lines

“…The criterium for histological diagnosis for IBC and IMC is the enormous neoplastic embolization of dermal lymphatic vessels which blockade lymphatic drainage originating the distinctive edema [4, 6–9]. The clinical form is characterized by a sudden presentation of erythema, firmness, warmth and pain resembling an inflammatory process and, therefore, this condition can be misdiagnosed with a dermatitis or mastitis, especially if a mammary nodule is absent [1, 2, 4–7]. Numerous epidemiologic, clinical and histopathological characteristics are shared by IBC and IMC, being the latter a good spontaneous animal model for the study of IBC [5, 10, 11].…”

Inflammatory breast cancer defined: proposed common diagnostic criteria to guide treatment and research

“…There can be ridges or indurations palpable within the skin, corresponding to the areas of lymphatic involvement, which are not contiguous. Ulceration or nodularity of the skin is less likely associated with IBC than with the more indolent LABC [9]. Whereas evidence of skin thickening is best seen with Magnetic Resonance (MR) imaging, conventional mammography and ultrasound can also detect this feature [10][11][12].…”