Define IBC.
a rare form of advanced, aggressive invasive carcinoma characterized by dermal lymphatic invasion of tumor cells
List clinical features.
Peau d'orange
Erythematous, warm, and edematous skin plaques with prominent hair follicles that resemble orange peel
Caused by obstruction of the lymphatic channels due to tumor growth
Tenderness, burning sensation
Blood-tinged nipple discharge
Signs of metastatic disease (e.g., axillary lymphadenopathy)
Usually no palpable mass
Which diagnostic criteria have to be met?
Rapid onset of breast erythema, edema, warmth, and peau d'orange, with or without palpable mass on breast examination
Erythema involving at least one-third of the breast
Symptoms have been present for < 6 months
Core needle biopsy confirming the presence of invasive carcinoma
List further diagnostic tests.
Skin punch biopsy: patients who meet the diagnostic criteria should undergo at least two full-thickness skin punch biopsies
Further testing
Imaging: bilateral mammogram and ultrasound of regional lymph node
Receptor and HER2 gene testing
List DDs.
Mastitis
Paget disease of the breast
Breast abscess
Describe the treatment and prognosis.
Treatment: chemotherapy (possibly in combination with targeted therapy) PLUS radiation PLUS modified radical mastectomy
Prognosis: 5-year survival rate is ∼ 40%.
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