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inflammatory breast cancer; mastitis carcinomatosa
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
- no fever
- nipple retraction can occur
- in most cases a distinct breast mass not felt
Laboratory:
- complete blood count (CBC): no leukocytosis
Special laboratory:
- breast biopsy of inflammed tissue
Diagnostic criteria:
- based upon clinical appearance [1]
Radiology:
- not diagnostic, part of staging for breast cancer
- CT of abdomen & thorax
- bone scan [1]
Differential diagnosis:
- can mimic acute mastitis
- mastitis commonly occurs in lactating women
Complications:
- high risk for metastases [1]
Management:
- neoadjuvant chemotherapy or endocrine therapy, mastectomy & adjuvant radiation therapy [1]
General
breast cancer
mastitis
References
- 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
- 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: 18258987
- 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: 21310844