Mammographic patterns of inflammatory breast carcinoma: a retrospective study of 92 cases.
OBJECTIVE
To quantitate initial mammographic signs and to describe post-therapeutic patterns of inflammatory breast cancer.


METHODS
Two radiologists retrospectively analyzed the initial clinical and mammographic findings of 92 patients with inflammatory breast carcinoma. The post-therapeutic mammogram (n = 75) was considered abnormal when focal opacity and or malignant-type microcalcifications were still visible.


RESULTS
Redness of the skin, "peau d'orange' and increased temperature were the most common findings. A palpable mass was noted in 97% with axillary lymph node involvement in 83% of cases. All initial mammograms were abnormal. Isolated inflammatory signs were observed in 14% and malignant signs in 86% of patients (opacity = 77% and/or malignant-type microcalcifications = 47%). Skin thickening was seen in 93.5%, nipple inversion in 56.5%, increased breast density in 93.5%, stromal coarsening in 85% and hypervascularisation in 32.5% of mammograms. On post-therapeutic mammograms, 35 patients (46.5%) were suspected of having residual disease. During follow-up, 19 patients (25.3%) relapsed locally: 75% had abnormal post-therapeutic mammograms.


CONCLUSIONS
The presence of isolated inflammatory signs on the mammogram is sufficient to suspect inflammatory breast carcinoma and biopsy must be performed in doubtful cases. Radical surgery is indicated when persistent malignant signs are still visible on mammogram after conservative treatment.
Tardivon
A A
AA
Department of Radiology, Institut Gustave Roussy, Villejuif, France.
Viala
J
J
Corvellec Rudelli
A
A
Guinebretiere
J M
JM
Vanel
D
D
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary / Q000601:surgery / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001706:Biopsy; D001940:Breast / Q000098:blood supply; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery / Q000628:therapy; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D004890:Erythema / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008327:Mammography; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology; D009558:Nipples / Q000473:pathology; D010173:Palpation; D011182:Postoperative Care; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology; D012881:Skin Temperature