Inflammatory breast cancer

Inflammatory breast cancer (IBC) is an extremely aggressive disease that progresses rapidly and carries a very grim prognosis. It is characterized by erythema, rapid enlargement of the breast, skin ridging, and a characteristics peau d´orange appearance of the skin secondary to dermal lymphatic tumor involvement. Although a palpable tumor may not by present, about 55% to 85% of patient will present with metastases to the axillary or supraclavicular lymph nodes. Diagnosis of IBC is made on the basis of these clinical characteristics, as well as histologic verification of carcinoma. Accurate diagnosis is critically important, as multimodal therapy can significantly improve outcome if instituted early enough. Primary systemic treatment (neoadjuvant, induction, initials) is standard treatment for inflammatory breast cancer. If treatment response is not satisfactory it is necessary to look for new treatment regimens with different concept of dose intensity, density and sequence of treatment. In the neoadjuvant setting it is possible to employ all targeted and non-targeted therapies as was shown in a number of clinical trials. (author)