Clinical aspect of inflammatory breast cancer: Diagnosis, criteria, controversy

Inflammatory breast cancer (IBC) is a rare and aggressive subtype of breast cancer, and its diagnosis is primarily clinical. IBC follows an aggressive biological course that is typically associated with rapid onset of symptoms and signs, and it is associated with poor overall outcome. Diagnosis of IBC is based on a combination of information derived from medical history, physical examination, and biopsy-confirmed presence of invasive cancer. Patients with IBC typically present with a history of less than 6 months of rapid breast enlargement, erythema, skin ridging, and peau d’orange appearance of the overlying skin, with or without an underlying palpable mass. Because of a lack of consensus on IBC case definition, it has been difficult to definitively determine incidence, identify specific risk factors, and compare studies to evaluate the effectiveness of different therapeutic modalities. In this chapter, we will discuss the clinical characteristics of IBC, methods that have been developed to better define this disease, the controversy surrounding case definition and its associated implication, and the diagnostic criteria established in a consensus statement released by a panel of international experts on IBC.