Inflammatory breast carcinoma

Inflammatory breast carcinoma

  • Breast cancer may clinically present with local erythema, warmth, and tenderness, similar to mastitis
    • Inflammatory breast cancer may be very difficult to distinguish from granulomatous mastitis. Inflammatory breast cancer often shows a peau d’orange surface, thickening, edema, and nipple retraction, but these findings also may be seen in some patients with mastitis, particularly if the mastitis is chronic 
  • Mammographic findings of mastitis may include skin and trabecular thickening and indistinct or, if an abscess is present, even spiculated masses 
  • Any case of mastitis that does not respond to standard treatment or that presents in an atypical way should raise suspicion for breast cancer, especially in nonlactating and postmenopausal women
    • Atypical cases can include those with no signs of trauma (eg, abrasion, papule) and no focal area of infection of the breast
    • Referral to breast surgeon for biopsy of breast, including skin, is the appropriate diagnostic procedure in suspicious cases
  • Histologic appearance differentiates mastitis from inflammatory breast carcinoma
    • In inflammatory breast carcinoma, histologic samples demonstrate diffuse occlusion or obstruction of dermal and/or subcutaneous lymphatic and vascular channels by tumor emboli 
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