Sonographic Features of Inflammatory Breast Cancer

Abstract

D t c s i Inflammatory breast carcinoma (IBC) is an aggressive form of invasive breast cancer characterized by diffuse erythema and edema (peau d’orange) of the breast, often without an underlying mass. IBC is usually a diagnosed on clinical examination with variable and nonspecific imaging findings. This aggressive cancer takes its name from the associated inflammatory-like symptoms that arise primarily from cancer cells blocking dermal lymphatics.1 The earliest documentation of IBC was in 1814, by Sir Charles Bell, who described a purple color on the skin over a breast tumor and shooting pains that were associated with the tumor.2 In 1924, Lee and Tannenbaum3 described “inflammatory breast cancer.” Dermal lymphatic invasion in IBC was described by Taylor and Meltzer in 1938.4 The possibilty of intraparenchymal lymphatic involvement being diagostic for IBC, in the absence of dermal lymphatic involveent, has also been suggested.5 According to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program, the incidence of IBC in 9 geographic areas of the United States was 6% among white women with breast cancer and 10% among black women with breast cancer between 1975 and 1981.6 Lower percentages were observed by other investigators, ranging from 0.5% to 1.3%.7-10 This difference may be related o the inclusion of locally advanced breast cancer cases mong IBC cases in the SEER database, resulting in an apparntly greater incidence of IBC. In a review of more recent EER data, from 1988 to 2000, investigators reported that BC comprised 2% of all breast malignancies.11 The incidence of IBC increased from 2.0% to 2.5% between 1988 and 1990 and 1997 and 1999, whereas the incidence of locally advanced breast cancers and non-T4 cancers decreased. The cause of the increase in the incidence of IBC is not known, but possible theories include heightened awareness, im-