Updated: November 2004

Inflammatory breast cancer or T4d tumours present with rapid development of swelling, redness and peau d'orange (skin edema) which is often mistaken for an infection and treated with antibiotics before the correct diagnosis is made. A mass may be palpable or the breast may be diffusely involved. The mammogram may show a discrete mass, but often there is only diffuse increase in density and skin thickening. Although the diagnosis is primarily a clinical one, the distinctive pathological finding is the involvement of the dermal lymphatic vessels by tumour cells which results in the skin erythema and edema. A biopsy (either core or open)  to confirm the diagnosis should include skin for the examination of dermal lymphatics. More extensive surgery is not part of the initial management.

Inflammatory breast cancer is the most aggressive form of breast cancer with a median survival of 18 to 24 months, despite intensive combined modality treatment leading to a high initial response. Prompt initial referral to the BC Cancer Agency is suggested for these patients. Clinical trials are available and participation should be encouraged.

Inflammatory breast cancer should be managed like other inoperable locally advanced breast cancer (stage IIIB and C) (follow this link).