Defining the clinical diagnosis of 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 characteristic peau d'orange appearance of the skin secondary to dermal lymphatic tumor involvement. Although a palpable tumor may not be present, about 55% to 85% of patients 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 histopathologic verification of carcinoma. Accurate diagnosis is critically important, as multimodal therapy can significantly improve outcomes if instituted early enough.