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Inflammatory breast cancer

Breast Cancer Essentials: Perspectives for Surgeons, Page: 623-634
2021
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Book Chapter Description

Inflammatory breast cancer is an aggressive, poor prognosis breast cancer subtype, comprising less than 5% of all mammary malignancies. Due to the radical involvement of skin, it is generally included in the "chest wall disease" spectrum of breast tumors. IBC represents a peculiar clinical entity of breast cancer, characterized by inflammatory signs and symptoms, edema of the breast, and a dire prognosis. No pathognomonic pathology finding is required to confirm the diagnosis, though suggestive ones can be described. The management of IBC is always multidisciplinary, addressing the appropriate sequence of integrated and multimodal treatments to increase the locoregional control and reduce the risk of metastatic spread and recurrence, preserving the quality of life and preventing the chest wall dissemination. Systemic staging is always recommended, to rule out the presence of distant metastases. No role for conservative surgery is currently endorsed; intensity and selection of both radiation therapy and chemotherapy must be personalized, according to the clinical response to primary systemic chemotherapy, the clinicopathological features of the disease, occurrence of pathological complete response, and tolerance of therapy. For the poor prognosis of nonresponders and recurrent patients, research development is implementing strategies to increase the rates of curable resections, adding on immunotherapy and targeted and biologic agents, and prolong the control of advanced disease, maximizing the quality of life.

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