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Inflammatory Breast Carcinoma (Sonographic Appearance by Rebecca Flick…

- - - - “Figure 4. Axillary ultrasound. a: lymph node with benign appearance retaining a fine cortex and an echogenic hilum; b: suspect lymph node showing irregular eccentric thickening of the cortex while the fatty hilum is conserved; c: very suspect lymph node, of increased thickness, with very thick cortex and virtual disappearance of the fatty hilum; d: Round, totally hypoechoic lymph node with metastatic appearance.”
    - - Figure 6. Right mammogram with MLO (a) and CC (b) incidence. Breast ultrasound of the surgical zone of the right sup. lat. quadrant (c) and ultrasound of the right axilla (d)
- - - - Inflammatory breast cancer is rare, but it is the most aggressive form of breast cancer and accounts for 1-6% of all breast malignancies. This type of breast cancer is characterized as “inflammatory” due to the swollen, discolored, or inflamed appearance. There are two clinical varieties of inflammatory breast cancer. The first is “Primary inflammatory breast cancer,” which is characterized by a sudden onset of symptoms in a breast that previously appeared normal. The second type, “Secondary inflammatory breast cancer,” is characterized by inflammatory signs and symptoms which appear in a breast with a previous mass. Primary inflammatory breast cancer represents true ‘‘inflammatory’’ breast cancer. It can be hard to distinguish between the two types, which results in inflammatory breast cancer being frequently misdiagnosed. The clinical signs and symptoms that make inflammatory breast cancer a unique clinical entity are rapidity of progression, high angiogenic and angioinvasive capability, and aggressive onset.
      - Cariati, M., Bennett-Britton, T. M., Pinder, S. E., & Purushotham, A. D. (2005). "inflammatory" breast cancer. Surgical Oncology, 14(3), 133. 10.1016/j.suronc.2005.07
    - - Women who are diagnosed with IBC have a poor survival outcome when compared to groups of women with non-IBC tumors.
        Roswell Park-Led Team Identifies Mechanism of Chemotherapy Resistance in Inflammatory Breast Cancer. (2014, July 12). India Pharma News.
        
        The patient must have duration of history no more than 6 months, erythema occupying at least one-third of the breast, pathological confirmation of invasive carcinoma, marker evaluation including hormones receptors and HER2 imaging, as well as a core biopsy to confirm invasive carcinoma. It is recommended that every patient who meets the diagnostic criteria for IBC undergo at least two skin punch biopsies. All women suspected having IBC must have a mammogram accompanied by ultrasound of the breast and regional lymph nodes.
        Roswell Park-Led Team Identifies Mechanism of Chemotherapy Resistance in Inflammatory Breast Cancer. (2014, July 12). India Pharma News.
  - - - Alunni, J. (2012). Imaging inflammatory breast cancer. Diagnostic and Interventional Imaging, 93(2), 95-103. doi:10.1016/j.diii.2011.12.003
      - Fig.2
- - - - FIG 1:
        
        "44-year-old woman with right inflammatory breast carcinoma. Axial contrast-enhanced T1-weighted VIBRANT MP (GE Healthcare) (top) and subtraction (bottom) images show enlarged right breast with global skin thickening and asymmetric diffuse nonmasslike parenchymal enhancement"
        
        Le-Petross, H. T., Cristofanilli, M., Carkaci, S., Krishnamurthy, S., Jackson, E. F., Harrell, R. K., Yang, W. T. (2011). MRI features of inflammatory breast cancer. AJR. American Journal of Roentgenology, 197(4), W769-W776. 10.2214/AJR.10.6157
    - - "67-year-old-woman with inflammatory breast carcinoma. Sagittal unenhanced T2-weighted image with fat suppression shows hyperintensity of breast parenchyma and chest wall (arrows) as a result of diffuse tissue edema."
        
        Le-Petross, H. T., Cristofanilli, M., Carkaci, S., Krishnamurthy, S., Jackson, E. F., Harrell, R. K., Yang, W. T. (2011). MRI features of inflammatory breast cancer. AJR. American Journal of Roentgenology, 197(4), W769-W776. 10.2214/AJR.10.6157
  - - - "45-year-old woman with right inflammatory breast carcinoma. Sagittal contrast-enhanced T1-weighted VIBRANT MP (GE Healthcare) image shows enhancing lesions (arrows) within thickened skin. Time–signal intensity curve shows delayed persistent enhancement of skin lesion on delayed phase."
        
        Le-Petross, H. T., Cristofanilli, M., Carkaci, S., Krishnamurthy, S., Jackson, E. F., Harrell, R. K., Yang, W. T. (2011). MRI features of inflammatory breast cancer. AJR. American Journal of Roentgenology, 197(4), W769-W776. 10.2214/AJR.10.6157
    - - "Mammogram. Skin thickening, Stromal trabecular coarsening and increased density"
      - R. M. Lorente Ramos1, J. Azpeitia Arman1, M. T. Rivera García1, E. Balbin Carrero2, I. Casado Fariñas1; 1Madrid/ES, 228031 Madrid/ES. (2013, December 31). Breast edema. A pictorial review with pathologic correlation. Retrieved March 01, 2018, from http://posterng.netkey.at/esr/viewing/index.php?module=viewing_poster&task=viewsection&pi=120920&ti=401765&searchkey=
  - - - "On H-E stains tumor cells emboli are found within dermal lymph vessels (arrows) "
      - R. M. Lorente Ramos1, J. Azpeitia Arman1, M. T. Rivera García1, E. Balbin Carrero2, I. Casado Fariñas1; 1Madrid/ES, 228031 Madrid/ES. (2013, December 31). Breast edema. A pictorial review with pathologic correlation. Retrieved March 01, 2018, from http://posterng.netkey.at/esr/viewing/index.php?module=viewing_poster&task=viewsection&pi=120920&ti=401765&searchkey=
  - - - "(A) PET/CT shows multicentric hypermetabolism in the right breast (arrow) associated with hypermetabolic diffuse skin thickening. (B) PET/CT shows a solitary focal hypermetabolic focus in the right lobe of the liver (arrows) that showed a maximum SUV of 5.7. Corresponding CT of the liver shows a focal hypoechoic mass with indistinct margins. (C) PET/CT shows a solitary focal hypermetabolic focus in the left proximal femur (arrows) that showed a maximum SUV of 7.7. Corresponding CT of the proximal femur shows this area of hypermetabolism to be within the marrow (whole body bone imaging was negative in this patient)"
      - Yang, W. T., Le-Petross, H. T., Macapinlac, H., Carkaci, S., Gonzalez-Angulo, A. M., Dawood, S., . . . Cristofanilli, M. (2008). Inflammatory breast cancer: PET/CT, MRI, mammography, and sonography findings. Breast Cancer Research and Treatment, 109(3), 417-426. 10.1007/s10549-007-9671-z