Abstract
Inflammatory breast carcinoma (IBC) is the most aggressive, lethal, and rare form of breast cancer and is characterized by the rapid development of erythema, edema, and peau d’orange over a third or more of the skin of the breast due to the occlusion of dermal mammary lymphatics by tumor emboli. IBC is associated with rapid progression, with a high risk of axillary lymph node involvement and distant metastases at initial diagnosis. The treatment plan is preoperative systemic chemotherapy [an induction regimen containing an anthracycline and a taxane (plus trastuzumab in HER2-positive patients)], followed by surgery and radiation therapy. The 5-year overall survival rate was less than 5% with only surgery, but with this multidisciplinary approach, the overall survival rates now range from 46% to 61%, and the 15-year survival rates vary between 20% and 30%. The response to primary chemotherapy is a strong indicator of survival. The 15-year survival rate is 44% in patients who achieve a pathologic complete response after primary chemotherapy. In this chapter, preoperative systemic therapy for the disease is discussed after a brief outline of inflammatory breast carcinoma.
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