Characterisation of Inflammatory Breast Cancer in Egypt

Abstract

IBC is a rare and fatal type of breast cancer and is considered as a separate entity, representing about 2.5% of all breast malignancies and 7% of all breast cancer-related deaths in the USA. IBC affects younger women with median age at diagnosis of 57 years. IBC is classified as T4d by UICC TNM classification system. Until now, there is no definitive molecular or pathological diagnostic criteria for IBC, and diagnosis is mainly clinically and confirmed by invasive underlying pathology. Clinically, IBC is presented by rapid onset, within 6 months, and progressive course of erythema of at least one-third of the breast, warmth and dermal edema (i.e. peau d’orange), with or without an underlying palpable mass. More than half of the patients are presented with metastasis to axillary LNs and up to one-third of the patients have distant metastasis at diagnosis. Dermal lymphatic tumor emboli in a skin punch biopsy is a hallmark and pathognomonic of IBC but not required for diagnosis. HR, HER2 and Ki67 are important to define the molecular subtypes of IBC according to IHC, to predict the prognosis, and to optimize therapeutic regimens. In Egypt, IBC represents about 11% of all breast cancer cases. IBC patients are younger than non-IBC patients, with median age of 49 years. In this study, we retrospectively reviewed medical records of female patients diagnosed as IBC at Breast Surgery Unit at Ain Shams University Hospitals from July 2007 through June 2017. Diagnosis was by clinical criteria and pathological confirmation. Patients with secondary skin changes from locally advanced breast cancer and patients with inflammatory recurrence after non-IBC were excluded.