Inflammatory Breast Cancer — Does the Confirmation of Dermal Lymphatic Invasion Predict the Worst Outcome?

Abstract

Inflammatory breast carcinoma (IBC) is a rare but aggressive breast cancer (BC) subtype. General prognosis is poor with higher incidence of axillary node involvement and metastatic disease at presentation (~30 %) as compared with common BC (~10 %). The typical IBC is characterised by rapid onset of localised or generalised skin redness, involving at least one-third of the breast, warmth and usually presence of skin oedema (peau d’orange), often without an underlying tumour mass. This clinical presentation of skin inflammation is a consequence of pathological plugging of the dermal lymphatic of the breast with tumour emboli. Dermal lymphatic invasion (DLI), although not mandatory for IBC diagnosis, is one of the hallmarks of this malignancy and can be proven in up to 75–80 % of IBCs. Surprisingly, there are very few data regarding whether the presence of DLI independently contributes to IBC prognosis as compared with IBC without DLI.