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