Abstract
The phenomenon of accelerated tumor growth following surgery has been observed repeatedly and merits further study. Inflammatory breast carcinoma (IBC) is widely recognized as an extremely aggressive malignancy characterized by micrometastasis at the time of diagnosis, with one interesting subgroup defined as secondary IBC where pathologically identifiable IBC appears after surgical treatment of a primary non-inflammatory breast cancer. One possible mechanism can be related to the stimulation of dormant micrometastasis through local angiogenesis occurring as part of posttraumatic healing. In this report, we review cases of secondary IBC and others where localized trauma was followed by the appearance of IBC at the traumatized site that have been identified by our IBC Registry (IBCR) and hypothesize that angiogenesis appearing as part of the healing process could act as an accelerant to an otherwise latent breast malignancy. It is therefore possible that secondary IBC can be used as a model to support local angiogenesis as an important contributor to the development of an aggressive cancer.
Highlights
Inflammatory breast cancer (IBC) is widely recognized as an extremely aggressive malignancy that is usually characterized by micro-metastases at the time of diagnosis
Our experience with IBC, noted in the case reports above, suggest that local trauma probably mediated in large part by angiogenesis can be an important trigger of IBC
We describe two cases compatible with secondary IBC that have been identified by our IBC Registry and two cases where IBC appeared at the site of local trauma
Summary
Inflammatory breast cancer (IBC) is widely recognized as an extremely aggressive malignancy that is usually characterized by micro-metastases at the time of diagnosis. IBC is characterized clinically as a rapidly growing tumor with skin manifestation of erythema, warmth and edema and pathologically by invasion of the dermal lymphatics with tumor microemboli. IBC affects approximately 2.5% of women with breast cancer annually in the United States and affects more than 4,800 women each year, more than twice as many as those developing chronic myelocytic leukemia or acute lymphocytic leukemia [2]. It is a clinically and pathologically distinct form of breast cancer that is fast growing, highly angiogenic and angioinvasive with its aggressiveness and angiogenicity present from its inception. We present examples of this possible phenomenon which could suggest a population of patients for further investigation
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