Inflammatory breast carcinoma (IBC) is the most aggressive manifestation of primary breast carcinoma. It is relatively rare, with an incidence of only 1%–6% in the U.S. African Americans have a higher incidence of IBC than do Caucasians and other ethnic groups (10.1%, 6.2%, and 5.1%, respectively). Furthermore, a review of the Surveillance, Epidemiology, and End Results (SEER) program data comparing trends and patterns for breast cancer between 1975–1977 and 1990–1992 revealed that the incidence of IBC increased from 0.3 to 0.7 cases per 100,000 person-years, a much larger increase than that observed for noninflammatory forms of breast cancer during the same period.The clinical presentation of IBC is quite characteristic and has been extensively described.Patients usually present with a rapid onset of swelling of the involved breast. The classic criteria for clinical diagnosis established by Haagensen include diffuse erythema, edema involving more than two-thirds of the breast, peau d’orange, tenderness, induration, warmth, enlargement, and diffuseness of the tumor on palpation. These symptoms usually progress rapidly, and patients frequently have axillary node involvement by the time they seek medical attention. Pathologically, there is extensive lymphovascular invasion by tumor emboli that involves the superficial dermal plexus of vessels in the papillary and high reticular dermis.
Compared with other types of breast cancer, inflammatory breast cancer tends to be diagnosed at younger ages.Inflammatory breast cancer is more common and diagnosed at younger ages in African American women than in white women.Inflammatory breast tumors are frequently hormone receptor negative, which means they cannot be treated with hormone therapies, such as tamoxifen, that interfere with the growth of cancer cells fueled by estrogen.Inflammatory breast cancer is more common in obese women than in women of normal weight.
Inflammatory breast cancer progresses rapidly, often in a matter of weeks or months. At diagnosis, inflammatory breast cancer is either stage III or IV disease, depending on whether cancer cells have spread only to nearby lymph nodes or to other tissues as well.