Differentiating Inflammatory Breast Cancer From Lactational Mastitis: A Diagnostic Challenge

Inflammatory breast cancer (IBC) is a rare but aggressive form of cancer; hence, early diagnosis is essential. Although predominantly occurring in older women, it can occur during pregnancy and lactation, making the diagnosis especially challenging. IBC is characterized by erythema and edema of the breast skin, with or without an underlying palpable mass. In pregnant and postpartum women, it can be easily confused with lactational mastitis. Awareness of the history and clinical signs of IBC, and how it differs from lactational mastitis, increases the likelihood that women will receive due care and have a chance at survival. Midwives play a key role in early recognition of breast abnormalities, given the multiple opportunities during pregnancy, birth, and the postpartum period to observe women's breasts. This Clinical Rounds article presents a real case of IBC in a postpartum woman. Discussion of the clinical presentation, diagnostic tips, and appropriate management options are included and compared with the diagnosis and management of lactational mastitis.