Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Am J Obstet Gynecol. 2021 Oct;225(4):392-396. doi: 10.1016/j.ajog.2021.04.217. Epub 2021 Apr 20.
Inflammatory breast cancer is a rare and aggressive malignancy that is often initially misdiagnosed because of its similar presentation to more benign breast pathologies such as mastitis, resulting in treatment delays. Presenting symptoms of inflammatory breast cancer include erythema, skin changes such as peau d' orange or nipple inversion, edema, and warmth of the affected breast. The average age at diagnosis is younger than in noninflammatory breast cancer cases. Known risk factors include African American race and obesity. Diagnostic criteria include erythema occupying at least one-third of the breast, edema, peau d' orange, and/or warmth, with or without an underlying mass; a rapid onset of <3 months; and pathologic confirmation of invasive carcinoma. Treatment of inflammatory breast cancer includes trimodal therapy with chemotherapy, surgery, and radiation. An aggressive surgical approach that includes a modified radical mastectomy enhances survival outcomes. Although the outcomes for patients with inflammatory breast cancer are poor compared with those of patients with noninflammatory breast cancer, patients with inflammatory breast cancer who complete trimodal therapy have a favorable locoregional control rate, underscoring the importance of a prompt diagnosis of this serious but treatable disease. Obstetrician-gynecologists and other primary care providers must recognize the signs and symptoms of inflammatory breast cancer to make a timely diagnosis and referral for specialized care.
炎性乳腺癌是一种罕见且侵袭性强的恶性肿瘤，由于其表现类似于乳腺炎等更良性的乳腺病变，因此常常被误诊，导致治疗延误。炎性乳腺癌的主要症状包括红斑、橘皮样皮肤改变或乳头内陷、水肿和受累乳房发热。诊断时的平均年龄较非炎性乳腺癌年轻。已知的危险因素包括非裔美国人种族和肥胖。诊断标准包括红斑占乳房的至少三分之一，水肿、橘皮样皮肤改变和/或发热，伴或不伴潜在肿块；发病迅速，<3 个月；病理证实为浸润性癌。炎性乳腺癌的治疗包括化疗、手术和放疗的三联疗法。改良根治性乳房切除术等积极的手术方法可提高生存结果。尽管与非炎性乳腺癌患者相比，炎性乳腺癌患者的预后较差，但完成三联疗法的炎性乳腺癌患者具有良好的局部区域控制率，这强调了及时诊断这种严重但可治疗疾病的重要性。妇产科医生和其他初级保健提供者必须认识到炎性乳腺癌的症状和体征，以便及时诊断和转介接受专业治疗。
