Teaching Case 16
43 y/o F presents with right breast pain and erythema for 1 month. What is the most likely diagnosis?
INFLAMMATORY BREAST CANCER
- 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.