Update on the Management of Inflammatory Breast Cancer

Abstract

Inflammatory breast cancer is a rare but highly aggressive form of locally advanced breast cancer. Inflammatory breast cancer accounts for about 5% of all cases of breast cancer. In general, women with inflammatory breast cancer present at a younger age, and with high prevelange among black races. IBC is more likely to have metastatic disease at diagnosis, and have shorter survival than women with non-inflammatory breast cancer. The characteristic pathologic finding is dermal lymphatic invasion by carcinoma, which can lead to obstruction of the lymphatic drainage causing the clinical picture of erythema and edema. Inflammatory carcinoma of the breast has distinct biological characteristics that differentiate it from non-inflammatory carcinoma. These tumors more often have a high S-phase fraction, are high-grade, are aneuploid, and lack hormone receptor expression and her2neu overexprestion. In addition, inflammatory carcinomas are more likely to have mutations in p53 and to have high levels of vascular endothelial growth factor (VEGF) which account for tumor neovascularization and the lymphotactic process in inflammatory breast cancer.