Locally advanced breast cancer with inflammatory component: a clinical entity with a poor prognosis

Locally advanced and inflammatory carcinomas of the breast are two distinct entities, with widely accepted differential clinical criteria. We describe a particular type of locally advanced cancer which acquires during its evolution inflammatory characteristics, although limited to a small area of skin and thus not accomplishing the common diagnostic criteria of inflammatory carcinoma. When comparing this type of tumors, named locally advanced cancer with inflammatory component, to other locally advanced cancers, some remarkable differences are found: there is a preponderance of younger patients, premenopausal or perimenopausal, with a greater percentage of poorly differentiated tumors and negative estrogen receptors. Their evolution and survival are similar to that of inflammatory carcinomas; thus, we conclude they should be considered and treated as inflammatory carcinomas. Finally, the prognostic limitations of the TNM classification are discussed and some adjustments for future classifications are suggested.