Management of Inflammatory Carcinoma of the Breast

Inflammatoryrcinoma of the breast is a clinical entity with no distinct histologic characteristics. The term is derived from the fact that the involved breast shows the cardinal signs and symptoms of inflammation—redness, heat, swelling, and pain. The condition was first described by Lee and Tannenbaum³²in 1924 and later emphasized by Taylor and Meltzer³³in 1938 as an uncommon variant of breast cancer. Haagensen's³¹diagnostic criteria are enlargement of the breast, either a distinct breast mass or generalized induration, redness and edema of the mammary skin, and biopsy proof of carcinoma; the redness must involve more than one third of the breast. This type of carcinoma is usually extremely undifferentiated with high-grade malignancy. There is extensive involvement and blockage of the dermal and subdermal lymphatics, resulting in edematous thickening and reddening of the skin, a characteristic pitted appearance known as "peau d'orange" or "pigskin." The disease is