Primary or true IBC: Locally advanced breast cancer (LABC) with rapid-onset (≤ 6 months) inflammatory skin changes, typically involving ≥ 1/3 of breast (T4d)
Diffuse breast erythema
Warmth, enlargement, pain, induration, edema
Peau d'orange (skin resembling orange peel)
Edema affecting ≥ 2/3 of breast
Secondary IBC: Appears after surgical treatment of noninflammatory breast cancer
Punch biopsy: Tumor emboli in dermal lymphatics; not required for or unique to diagnosis of IBC
Neoadjuvant chemotherapy (NAC): Chemotherapy prior to surgery
Adjuvant chemotherapy: Chemotherapy after surgery
Complete response (CR) to neoadjuvant chemotherapy (NAC): No clinical (cCR) or pathologic (pCR) disease
Partial response: Clinical ↓ in tumor size by > 50%
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Nuclear Medicine Findings
Image-Guided Biopsy
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Gutierrez Barrera AM et al: BRCA mutations in women with inflammatory breast cancer. Cancer. 124(3):466-474, 2018
Leong PW et al: Imaging features of inflammatory breast disorders: A pictorial essay. Korean J Radiol. 19(1):5-14, 2018
DeSnyder SM et al: Prospective Feasibility Trial of Sentinel Lymph Node Biopsy in the Setting of Inflammatory Breast Cancer. Clin Breast Cancer. ePub, 2017
Liu J et al: Chemotherapy response and survival of inflammatory breast cancer by hormone receptor- and HER2-defined molecular subtypes approximation: an analysis from the National Cancer Database. J Cancer Res Clin Oncol. 143(1):161-168, 2017
Nakhlis F et al: The Impact of Residual Disease After Preoperative Systemic Therapy on Clinical Outcomes in Patients with Inflammatory Breast Cancer. Ann Surg Oncol. 24(9):2563-2569, 2017
Rosso KJ et al: Improved Locoregional Control in a Contemporary Cohort of Nonmetastatic Inflammatory Breast Cancer Patients Undergoing Surgery. Ann Surg Oncol. 24(10):2981-2988, 2017
Rosso KJ et al: In response to "outcomes of patients with inflammatory breast cancer treated by breast conserving surgery": the argument against breast conservation and sentinel lymph node biopsy in IBC. Breast Cancer Res Treat. 165(3):779-781, 2017
van Uden DJP et al: Dynamic Contrast-Enhanced Magnetic Resonance Imaging in the Assessment of Inflammatory Breast Cancer Prior to and After Neoadjuvant Treatment. Breast Care (Basel). 12(4):224-229, 2017
Wang X et al: EGFR signaling promotes inflammation and cancer stem-like activity in inflammatory breast cancer. Oncotarget. 8(40):67904-67917, 2017
Abeywardhana DY et al: Review of ultrasound appearance in inflammatory breast cancer: A pictorial essay. J Med Imaging Radiat Oncol. 60(1):83-7, 2016
Brzezinska M et al: Outcomes of patients with inflammatory breast cancer treated by breast-conserving surgery. Breast Cancer Res Treat. 160(3):387-391, 2016
Loewen AH et al: Case Report: Hormone Receptor Positive, HER2/neu Negative Inflammatory Breast Cancer in a Male Patient. S D Med. 68(10):435-7, 439-40, 2015
van Uden DJ et al: Inflammatory breast cancer: an overview. Crit Rev Oncol Hematol. 93(2):116-26, 2015
Warren LE et al: Inflammatory Breast Cancer: Patterns of Failure and the Case for Aggressive Locoregional Management. Ann Surg Oncol. 22(8):2483-91, 2015
Wecsler JS et al: Lymph node status in inflammatory breast cancer. Breast Cancer Res Treat. 151(1):113-20, 2015
Akay CL et al: Primary tumor resection as a component of multimodality treatment may improve local control and survival in patients with stage IV inflammatory breast cancer. Cancer. 120(9):1319-28, 2014
Dawood S et al: Survival of women with inflammatory breast cancer: a large population-based study. Ann Oncol. 25(6):1143-51, 2014
Goldner B et al: Incidence of inflammatory breast cancer in women, 1992-2009, United States. Ann Surg Oncol. 21(4):1267-70, 2014
Rueth NM et al: Underuse of trimodality treatment affects survival for patients with inflammatory breast cancer: an analysis of treatment and survival trends from the National Cancer Database. J Clin Oncol. 32(19):2018-24, 2014
Yeh ED et al: What radiologists need to know about diagnosis and treatment of inflammatory breast cancer: a multidisciplinary approach. Radiographics. 33(7):2003-17, 2013
Yamauchi H et al: Inflammatory breast cancer: what we know and what we need to learn. Oncologist. 17(7):891-9, 2012
Dawood S et al: International expert panel on inflammatory breast cancer: consensus statement for standardized diagnosis and treatment. Ann Oncol. 22(3):515-23, 2011
Le-Petross HT et al: MRI features of inflammatory breast cancer. AJR Am J Roentgenol. 197(4):W769-76, 2011
Robertson FM et al: Inflammatory breast cancer: the disease, the biology, the treatment. CA Cancer J Clin. 60(6):351-75, 2010
Carkaci S et al: Retrospective study of 18F-FDG PET/CT in the diagnosis of inflammatory breast cancer: preliminary data. J Nucl Med. 50(2):231-8, 2009
Hidar S et al: Sentinel lymph node biopsy after neoadjuvant chemotherapy in inflammatory breast cancer. Int J Surg. 7(3):272-5, 2009
Dawood S et al: Prognostic significance of HER-2 status in women with inflammatory breast cancer. Cancer. 112(9):1905-11, 2008
Le-Petross CH et al: Evolving role of imaging modalities in inflammatory breast cancer. Semin Oncol. 35(1):51-63, 2008
Renz DM et al: Magnetic resonance imaging of inflammatory breast carcinoma and acute mastitis. A comparative study. Eur Radiol. 18(11):2370-80, 2008
Singletary SE et al: Defining the clinical diagnosis of inflammatory breast cancer. Semin Oncol. 35(1):7-10, 2008
Yang WT et al: Inflammatory breast cancer: PET/CT, MRI, mammography, and sonography findings. Breast Cancer Res Treat. 109(3):417-26, 2008
Thukral A et al: Inflammatory breast cancer: dynamic contrast-enhanced MR in patients receiving bevacizumab--initial experience. Radiology. 244(3):727-35, 2007
Chow CK: Imaging in inflammatory breast carcinoma. Breast Dis. 22:45-54, 2005
Hance KW et al: Trends in inflammatory breast carcinoma incidence and survival: the surveillance, epidemiology, and end results program at the National Cancer Institute. J Natl Cancer Inst. 97(13):966-75, 2005
Merajver SD et al: Inflammatory breast cancer. In Harris JR et al: Diseases of the Breast. 3rd ed. Philadelphia: Lippincott, Williams & Wilkins. 971-82, 2004
Cristofanilli M et al: Update on the management of inflammatory breast cancer. Oncologist. 8(2):141-8, 2003
Giordano SH et al: Inflammatory breast cancer: clinical progress and the main problems that must be addressed. Breast Cancer Res. 5(6):284-8, 2003
Stearns V et al: Sentinel lymphadenectomy after neoadjuvant chemotherapy for breast cancer may reliably represent the axilla except for inflammatory breast cancer. Ann Surg Oncol. 9(3):235-42, 2002
Kushwaha AC et al: Primary inflammatory carcinoma of the breast: retrospective review of mammographic findings. AJR Am J Roentgenol. 174(2):535-8, 2000
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Inflammatory breast cancer (IBC)
Definitions
Primary or true IBC: Locally advanced breast cancer (LABC) with rapid-onset (≤ 6 months) inflammatory skin changes, typically involving ≥ 1/3 of breast (T4d)
Diffuse breast erythema
Warmth, enlargement, pain, induration, edema
Peau d'orange (skin resembling orange peel)
Edema affecting ≥ 2/3 of breast
Secondary IBC: Appears after surgical treatment of noninflammatory breast cancer
Punch biopsy: Tumor emboli in dermal lymphatics; not required for or unique to diagnosis of IBC
Neoadjuvant chemotherapy (NAC): Chemotherapy prior to surgery
Adjuvant chemotherapy: Chemotherapy after surgery
Complete response (CR) to neoadjuvant chemotherapy (NAC): No clinical (cCR) or pathologic (pCR) disease
Partial response: Clinical ↓ in tumor size by > 50%
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Nuclear Medicine Findings
Image-Guided Biopsy
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Gutierrez Barrera AM et al: BRCA mutations in women with inflammatory breast cancer. Cancer. 124(3):466-474, 2018
Leong PW et al: Imaging features of inflammatory breast disorders: A pictorial essay. Korean J Radiol. 19(1):5-14, 2018
DeSnyder SM et al: Prospective Feasibility Trial of Sentinel Lymph Node Biopsy in the Setting of Inflammatory Breast Cancer. Clin Breast Cancer. ePub, 2017
Liu J et al: Chemotherapy response and survival of inflammatory breast cancer by hormone receptor- and HER2-defined molecular subtypes approximation: an analysis from the National Cancer Database. J Cancer Res Clin Oncol. 143(1):161-168, 2017
Nakhlis F et al: The Impact of Residual Disease After Preoperative Systemic Therapy on Clinical Outcomes in Patients with Inflammatory Breast Cancer. Ann Surg Oncol. 24(9):2563-2569, 2017
Rosso KJ et al: Improved Locoregional Control in a Contemporary Cohort of Nonmetastatic Inflammatory Breast Cancer Patients Undergoing Surgery. Ann Surg Oncol. 24(10):2981-2988, 2017
Rosso KJ et al: In response to "outcomes of patients with inflammatory breast cancer treated by breast conserving surgery": the argument against breast conservation and sentinel lymph node biopsy in IBC. Breast Cancer Res Treat. 165(3):779-781, 2017
van Uden DJP et al: Dynamic Contrast-Enhanced Magnetic Resonance Imaging in the Assessment of Inflammatory Breast Cancer Prior to and After Neoadjuvant Treatment. Breast Care (Basel). 12(4):224-229, 2017
Wang X et al: EGFR signaling promotes inflammation and cancer stem-like activity in inflammatory breast cancer. Oncotarget. 8(40):67904-67917, 2017
Abeywardhana DY et al: Review of ultrasound appearance in inflammatory breast cancer: A pictorial essay. J Med Imaging Radiat Oncol. 60(1):83-7, 2016
Brzezinska M et al: Outcomes of patients with inflammatory breast cancer treated by breast-conserving surgery. Breast Cancer Res Treat. 160(3):387-391, 2016
Loewen AH et al: Case Report: Hormone Receptor Positive, HER2/neu Negative Inflammatory Breast Cancer in a Male Patient. S D Med. 68(10):435-7, 439-40, 2015
van Uden DJ et al: Inflammatory breast cancer: an overview. Crit Rev Oncol Hematol. 93(2):116-26, 2015
Warren LE et al: Inflammatory Breast Cancer: Patterns of Failure and the Case for Aggressive Locoregional Management. Ann Surg Oncol. 22(8):2483-91, 2015
Wecsler JS et al: Lymph node status in inflammatory breast cancer. Breast Cancer Res Treat. 151(1):113-20, 2015
Akay CL et al: Primary tumor resection as a component of multimodality treatment may improve local control and survival in patients with stage IV inflammatory breast cancer. Cancer. 120(9):1319-28, 2014
Dawood S et al: Survival of women with inflammatory breast cancer: a large population-based study. Ann Oncol. 25(6):1143-51, 2014
Goldner B et al: Incidence of inflammatory breast cancer in women, 1992-2009, United States. Ann Surg Oncol. 21(4):1267-70, 2014
Rueth NM et al: Underuse of trimodality treatment affects survival for patients with inflammatory breast cancer: an analysis of treatment and survival trends from the National Cancer Database. J Clin Oncol. 32(19):2018-24, 2014
Yeh ED et al: What radiologists need to know about diagnosis and treatment of inflammatory breast cancer: a multidisciplinary approach. Radiographics. 33(7):2003-17, 2013
Yamauchi H et al: Inflammatory breast cancer: what we know and what we need to learn. Oncologist. 17(7):891-9, 2012
Dawood S et al: International expert panel on inflammatory breast cancer: consensus statement for standardized diagnosis and treatment. Ann Oncol. 22(3):515-23, 2011
Le-Petross HT et al: MRI features of inflammatory breast cancer. AJR Am J Roentgenol. 197(4):W769-76, 2011
Robertson FM et al: Inflammatory breast cancer: the disease, the biology, the treatment. CA Cancer J Clin. 60(6):351-75, 2010
Carkaci S et al: Retrospective study of 18F-FDG PET/CT in the diagnosis of inflammatory breast cancer: preliminary data. J Nucl Med. 50(2):231-8, 2009
Hidar S et al: Sentinel lymph node biopsy after neoadjuvant chemotherapy in inflammatory breast cancer. Int J Surg. 7(3):272-5, 2009
Dawood S et al: Prognostic significance of HER-2 status in women with inflammatory breast cancer. Cancer. 112(9):1905-11, 2008
Le-Petross CH et al: Evolving role of imaging modalities in inflammatory breast cancer. Semin Oncol. 35(1):51-63, 2008
Renz DM et al: Magnetic resonance imaging of inflammatory breast carcinoma and acute mastitis. A comparative study. Eur Radiol. 18(11):2370-80, 2008
Singletary SE et al: Defining the clinical diagnosis of inflammatory breast cancer. Semin Oncol. 35(1):7-10, 2008
Yang WT et al: Inflammatory breast cancer: PET/CT, MRI, mammography, and sonography findings. Breast Cancer Res Treat. 109(3):417-26, 2008
Thukral A et al: Inflammatory breast cancer: dynamic contrast-enhanced MR in patients receiving bevacizumab--initial experience. Radiology. 244(3):727-35, 2007
Chow CK: Imaging in inflammatory breast carcinoma. Breast Dis. 22:45-54, 2005
Hance KW et al: Trends in inflammatory breast carcinoma incidence and survival: the surveillance, epidemiology, and end results program at the National Cancer Institute. J Natl Cancer Inst. 97(13):966-75, 2005
Merajver SD et al: Inflammatory breast cancer. In Harris JR et al: Diseases of the Breast. 3rd ed. Philadelphia: Lippincott, Williams & Wilkins. 971-82, 2004
Cristofanilli M et al: Update on the management of inflammatory breast cancer. Oncologist. 8(2):141-8, 2003
Giordano SH et al: Inflammatory breast cancer: clinical progress and the main problems that must be addressed. Breast Cancer Res. 5(6):284-8, 2003
Stearns V et al: Sentinel lymphadenectomy after neoadjuvant chemotherapy for breast cancer may reliably represent the axilla except for inflammatory breast cancer. Ann Surg Oncol. 9(3):235-42, 2002
Kushwaha AC et al: Primary inflammatory carcinoma of the breast: retrospective review of mammographic findings. AJR Am J Roentgenol. 174(2):535-8, 2000
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