Teaching Case 16

43 y/o F presents with right breast pain and erythema for 1 month. What is the most likely diagnosis?


  • Relatively uncommon aggressive form of invasive breast cancer
  • Enlarged breast within short onset
  • Indurated, erythematous, warm, and may be tender/painful (not always)
    • “Peau d’orange” appearance
  • Mimics mastitis clinically
  • Unilateral axillary lymphadenopathy in ~50% of cases
  • Path: Dermal lymphatic invasion of tumor cells
  • T4 disease (TNM staging)
  • Diffuse skin thickening on mammo/US/MRI
  • MRI: mass or multiple (73%) – typically small and confluent
  • Tx: Chemotherapy first, then typically mastectomy and radiation

Related Radiology Article: Yeh ED, Jacene HA, Bellon JR, Nakhlis F, Birdwell RL, Georgian-Smith D, Giess CS, Hirshfield-Bartek J, Overmoyer B, Van den Abbeele AD. What radiologists need to know about diagnosis and treatment of inflammatory breast cancer: a multidisciplinary approach. Radiographics. 2013 Nov;33(7):2003-17.