Abstract
Inflammatory breast cancer (IBC) is an uncommon but relatively aggressive malignancy. Primary IBC presents with rapid-onset breast edema, erythema, and skin thickening, often without an associated discrete breast mass. Bilateral mammogram and targeted ultrasound should always be performed for further evaluation of these symptoms, but some cases of IBC will nonetheless be difficult to distinguish from benign mastitis. Suspected cases of mastitis should be biopsied if symptoms fail to respond to a course of antibiotics. Diagnostic biopsy options include punch biopsy and/or percutaneous core needle biopsy, and immunohistochemistry to evaluate for estrogen receptor, progesterone receptor, and HER2/neu expression is essential. Following diagnostic biopsy, initial work-up should include body imaging to rule out overt distant metastases and stage 4 disease. Management of nonmetastatic IBC is multidisciplinary in nature, consisting of neoadjuvant chemotherapy followed by modified radical mastectomy and postmastectomy radiation. Targeted endocrine or anti-HER2/neu therapies have resulted in improved rates of locoregional control as well as survival.
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