Inflammatory Breast Cancer: Diagnostic, Molecular and Therapeutic Considerations

Abstract

Inflammatory breast cancer (IBC) is an aggressive type of breast cancer with poor prognosis. Treatment for non-metastatic disease is neoadjuvant chemotherapy followed by mastectomy and radiation. IBC diagnosis is primarily a clinical diagnosis, which can lead to misdiagnosis and delayed management. In addition, there are no molecular criteria for diagnosis or therapeutic regimens developed specifically for IBC. We aimed to discuss recent developments in IBC, including diagnosis, molecular mechanisms, and treatment. Recently, the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC) breast cancer staging system has defined the diagnostic features of IBC. Current molecular characterization of IBC has not revealed a unique signature or marker for diagnosis; however, this work sheds light on the pathophysiology of IBC and provides potential therapeutic targets. The prognosis of IBC remains poor, although the survival is improved significantly with trimodal management. To date, a consensus on diagnosis and prospective trials specifically designed for IBC therapy are lacking. Standardized criteria incorporating clinical, pathologic, and molecular criteria remains an unmet need. Recent consensus recommendations regarding diagnosis and management are reviewed with a view towards evolving molecular characterization, potential targets, and current clinical trials.