Inflammatory carcinoma of the breast is considered a rare, aggressive, advanced form of breast cancer that is characterized by dermal lymphatic invasion of tumor cells.
Histologically, inflammatory carcinoma involves extensive blockage of the lymphovascular dermis with carcinoma cells. In other words, the tumor cells invade the dermal lymphatics.
Inflammatory carcinoma can often be confused with other similar conditions e.g. mastitis and Paget disease of the breast. Inflammatory invasive carcinoma is not necessarily an inflammatory condition as inflammation is not present. Instead, the underlying pathophysiology involves diffuse infiltrates of the dermis.
The presence of a tumor leads to impaired lymphatic drainage and subsequent lymphedema. This leads to tightening of the skin which leaves the skin of the breast resembling an orange peel. The impaired lymphatic drainage can also cause hair follicle pitting and erythema.
Breast tenderness is associated with inflammatory carcinoma. This can be useful in terms of diagnosis as most breast cancers, if palpable, will be non-tender.
Inflammatory carcinoma of the breast can also present with bloody nipple discharge.
Inflammatory carcinoma is associated with a poor prognosis due to the time of presentation relating to likely metastases. Thus, there is a 50% survival rate at 5 years from diagnosis.
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