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The Role of Imaging in Diagnosing and Managing the Treatment of Inflammatory Breast Cancer

Mark P. Bowes, PhD

*Medical Writer, Portland, Oregon.
Address correspondence to: Mark P. Bowes, PhD, Medical Writer, 7135 SE 18th Avenue, Portland, OR 97202. E-mail: mpbowes@gmail.com.

Disclosure Statement: Dr Bowes reports having no financial or advisory relationships with corporate organizations related to this activity.

ABSTRACT

Inflammatory breast cancer (IBC) is a relatively rare but aggressive form of breast cancer that is characterized by breast redness and swelling, skin thickening, and the lack of a well-defined palpable mass. Patients with IBC are more likely than those with other types of breast cancer to have metastatic disease at the time of diagnosis, and the long-term prognosis for these patients is poor. The early recognition of IBC is often challenging and treatment guidelines have only recently described IBC as a distinct clinical entity with its own treatment algorithm. There are no specific molecular or genetic characteristics that distinguish IBC from other types of breast cancer, and the diagnosis depends on clinical and histological evaluation. Imaging is a critical part of the workup of suspected IBC. Mammography is usually the preferred imaging modality for examining patients with suspected IBC. Sonography is especially useful in fine needle guided biopsy and examining the lymph nodes. Although not recommended as a first-line approach for evaluation of suspected IBC, magnetic resonance imaging provides high spatial resolution, and the addition of intravenous contrast may permit visualization of changes that are not evident with mammography or ultrasonography. Positron-emission tomography/computed tomography is a newer technique that is increasingly being used to evaluate patients with IBC. It is especially useful for examining lymph nodes and distant metastasis. This article discusses the diagnosis and treatment of IBC, which depends on a multimodal approach that requires the close cooperation of medical professionals from several specialties, including medical and radiation oncology, surgery, radiology, and pathology. Various imaging techniques are described, along with the typical imaging findings and the strengths and limitations of each imaging method.

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