Inflammatory breast cancer-importance of breast imaging.

Vasiliki Papalouka, Fiona J Gilbert

OAI: oai:www.repository.cam.ac.uk:1810/279388 • DOI: 10.17863/CAM.26764

Inflammatory breast cancer (IBC) is a rare form of primary cancer and accounts for only 1-5 % of all breast cancer types.[1–3] It is classified as T4d stage by TNM classification,[4] the most aggressive form of breast cancer with a 20%–30% incidence of distant metastasis at the time of diagnosis[5] and poorer prognosis than the non-IBC locally advanced breast cancers. [6–8] IBC diagnosis is purely based on clinical criteria, including rapid onset of breast erythema, oedema involving at least one third of the breast and “peau d’orange” appearances of the skin, with or without a palpable breast lump, combined with a histopathological confirmation of an invasive breast carcinoma.[9,10] Although there are no established data to support specific radiological findings with IBC, imaging plays a core role in diagnosis, staging and management of the disease. Full field digital mammography (FFDM), high-resolution ultrasonography (US) and magnetic resonance imaging (MRI) are key modalities for an optimal initial investigation, identifying the extent of the breast cancer and facilitating an imaging- guided core biopsy to establish histopathology diagnosis. Imaging is also to helpful to differentiate other breast pathologies which may mimic IBC, such as inflammatory breast conditions or other locally advanced tumours. Initial imaging is also important in order to define the locoregional staging, the nodal status of the disease and the presence of contralateral breast pathology. Positron emission tomography (PET/CT), Computed Tomography (CT) and whole-body scintigraphy can also help in oncological, surgical and radiotherapy planning by identifying distant metastatic disease and detecting regional and distant nodal involvement. Furthermore, imaging has an important role in monitoring and evaluation of response to primary systemic chemotherapy, which is currently the first line of treatment [7]in IBC and in surveillance/ follow up patients following modified mastectomy and radiotherapy. [11]

MRI Mammography ULTRASOUND Breast Diagnostic Imaging Female Humans Inflammatory Breast Neoplasms Reproducibility of Results