Inflammatory Breast Cancer

IMAGING FINDINGS: ​​

Screening mammography shows skin thickening and subtle trabecular thickening involving the left breast.
 
WHY IT MATTERS:

1. Inflammatory breast cancer (IBC) is a rare, aggressive form of breast cancer. It presents as rapid onset of skin erythema and thickening.
   
2. The differential diagnosis initially includes mastitis.  However, IBC is usually painless while mastitis tends to be very painful and can cause systemic symptoms like fever.  A trial of antibiotics can help to distinguish the two etiologies as mastitis resolves and IBC does not.
   
3. The differential diagnosis also includes locally advanced breast cancer that has spread to the overlying skin. Usually with true inflammatory breast cancer there is no underlying mass.
   

FURTHER READING:
What Radiologists Need to Know about Diagnosis and Treatment of Inflammatory Breast Cancer: A Multidisciplinary Approach (RadioGraphics, 2013)