Inflammatory breast cancer(IBC) is a relatively uncommon and biologically aggressive form of breast cancer characterized by a high rate of local-regional recurrence and early systemic dissemination. To determine the clinical and histopathological
characteristics, we performed retrospective review of 9 patients with nometastatic clinical inflammatory breast cancer treated at Kangnam St. Mary's Hospital between 1991 and 1994. The diagnosis of IBC is defined by either presence of clinical
evidence
of infalmmation or presence of tumor cell emboli in the dermal lymphatics. The prevalent rate of IBC is 2.9%(9 out of 310 cases). All 9 patients had a histologic diagnosis of infiltrating ductal carcinoma. The median age of all patients was 48
years
(range 36~63). Four patients(44.4%) are premenopausal and five patients (55.6%) are postmenopausal. Edema of the skin is the most common symptom(100%) following redness of the skin(55.6%), nipple retraction, pain and bloody nipple discharge in
decreasing order of frequence. 8 patients had pathologically axillary lymph node involvement. Dermal lymphatic invasion was shown in 5 patients(55.6%). 6 patients(66.7%) received a 3 preoperative chemotherapy cycles. 5 patients(83.3%) had PR and
1
patient(16.7%) had NC after preoperative chemotherapy. Modified radical mastectomy was perofrmed and postoperative irradiation was administered in all patients. With a median follow-up of 19.5 months in all patients, the median disease free
survival was
18.8 months and local-regional recurrence rate was 33.3%.
In spite of short follow-up period, the author concludes that IBC is more aggressive than any other breast cancer and is associated with a high risk of dissemination. Multimodality therapy including preoperative chemotherapy, surgery, radiation
and
postoperative chemotherapy may be beneficial in treatment of IBC. For the purpose of increasing survival rate and preventing local-regional recurrence, the use of accelerated fractionation radiation and dose intense chemotherapy will be required.
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