Inflammatory Breast Cancer Cases Research Articles

Breast cancer in patients under 18 years. Report of an inflammatory case and review of the literature

We report a case of inflammatory breast cancer in an 11-year-old girl. She was treated with chemotherapy, surgery and radiotherapy, followed by intensification and autologous bone marrow transplantation. She relapsed 8 months after the end of treatment and died 2 months later with polymetastatic disease. Genetic studies did not identify any mutation of the p53 gene. Sixty-four cases of breast cancer in patients under 18 years have been reported. Thirty-eight were sufficiently described to be discussed. In two-thirds of patients, pathologic examination showed a secretory juvenile carcinoma. Prognosis in this group was good with only one death reported. In the other patients, poorly differentiated or inflammatory carcinomas were described. Mortality in this group is high. Well differentiated carcinoma were reported in two patients. Paediatric breast cancer appears to be different from the adult disease with regard to history, sex ratio and prognosis. Therapeutic implications are discussed.

A CASE OF METASTATIC GASTRIC CANCER OF INFLAMMATORY BREAST CANCER PRESENTING WITH LINITIS PLASTICA-LIKE LESION

A case of inflammatory breast cancer which metastasized to the stomach was experienced. A 43-year-old woman visited a nearby hospital because of swelling, redness, and pain of the bilateral breasts and erosion of the right nipple, and was referred to the hospital with a diagnosis of inflammatory breast cancer. Laboratory data showed elevated levels of alkaline phosphatase and tumor markers, such as BCA225 (5700 U/ml), NCC-ST439 (600 U/ml), and CA15-3 (250 U/ml). Chest X-ray film showed bilateral pleural effusion, of which adenocarcinoma cell was demonstrated by cytology. Bone scintigram demonstrated the multiple bone metastases. The patient was diagnosed as inflammatory breast cancer with metastases to the supraclavicular lymph nodes, bone and bilateral pleuritis carcinomatosa. After chemo-immuno-hormone therapy, she complained of loss of appetite. Abdominal X-ray film revealed findings of Borrmann type 4. Endoscopy showed an edema of the gastric mucosa and giant fold. Biopsy specimen demonstrated that the tumor was adenocarcinoma metastasized from breast cancer. Barium meal showed the rigidity of the gastric wall like linitis plastica. She died of respiratory failure about 5.5 months after the initial visit to the hospital. Metastasis to the stomach from breast cancer is rare. Most of them present as scirrhouslike lesions. A review of the Japanese literature is also described here.

Two distinct mechanisms alter p53 in breast cancer: mutation and nuclear exclusion.

Twenty-seven cases of inflammatory breast cancer were screened for the presence of the p53 protein by immunocytochemical methods using a monoclonal antibody directed against the p53 protein. Three groups were detected: 8 cases (30%) had high levels of p53 in the nucleus of the cancer cells; 9 cases (33%) had a complete lack of detectable staining; 10 cases (37%) showed a pattern of cytoplasmic staining with nuclear sparing. Nucleotide sequence analysis of p53 cDNAs derived from the samples with cytoplasmic staining revealed only wild-type p53 alleles in 6 out of 7 cases. An eighth case was determined to be wild type by a single-strand conformation polymorphism. In contrast, the samples containing nuclear p53 contained a variety of missense mutations and a nonsense mutation. The p53 cDNAs from 3 of the tumors that lacked detectable p53 staining were analyzed, and all 3 had wild-type nucleotide sequences. Interestingly, a case of normal lactating breast tissue also showed intense cytoplasmic staining for p53 with nuclear sparing. These data suggest that some breast cancers that contain the wild-type form of p53 protein may inactivate its tumor-suppressing activity by sequestering this protein in the cytoplasm, away from its site of action in the cell nucleus. The detection of cytoplasmic p53 in normal lactating breast tissue could suggest that this is the mechanism employed in specific physiological situations to permit transient cell proliferation. This observation could explain how some breast cancer tissues inactivate p53 function without mutation.

Inflammatory cancer of the breast: analysis of 114 cases.

One hundred and fourteen cases of inflammatory breast cancer were reviewed. Actuarial survival curves, independent of the stage and type of treatment, showed a median survival of less than 15 months. As regards the three different subgroups of 80, 14, and 20 women, N0-1-2M0, N3M1 respectively, the acutuarial survival curves showed figures of median survival that decreased from 14 to 4 months, according to the extent of the disease. Survival rates for the subgroups of patients treated by radical mastectomy, radical mastectomy followed by radiotherapy, and radiotherapy alone were not significantly different. Neither the more sophisticated therapeutic approaches intended to modify the hormonal medium of the patients, nor the combined chemotherapy plus radiotherapy, proved to be successful. Inflmmatory breast cancer should be considered a systemic disease; consequently, in spite of discouraging results, only a systemic therapeutic approach, consisting of aggressive combination chemotherapy and perhaps immunostimulation, seems worthwhile.