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Cancer images - inflammatory breast cancer
27 March 2023
Caution: this essay contains clinical images that may be disturbing to some.
Inflammatory breast cancer is an uncommon type of breast cancer characterized by the rapid onset (within 6 months) of an enlarged breast that is erythematous (red / pink), edematous (swollen) and has a peau d’orange appearance (resembling an orange peel) due to plugging of lymphatic vessels by tumor. Typically the erythema and edema must occupy at least 33% of the breast to make the diagnosis. It is termed inflammatory because the skin appears inflamed or infected.
Many breast cancer types are designated based on the microscopic appearance of the cells, such as ductal or lobular. Inflammatory breast cancer is designated based on the clinical appearance and the presence of tumor cells in lymphatic vessels, but the tumor cells themselves may be ductal or lobular or have a different appearance.
Although inflammatory breast cancer accounts for only 2 - 5% of all newly diagnosed breast cancer cases, it causes 7% of breast cancer related deaths, most likely because it typically presents with advanced disease at diagnosis. Its overall 5 year survival rate is 41% compared to 91% for breast cancer overall.
The bottom half of this image shows dilated lymphatic vessels with a small fragment of tumor near the top of the vessel in the lumen (opening).
This dilated lymphatic vessel shows obvious tumor.
There are large amounts of tumor in the lymphatic vessels and in the adjacent tissue.
These patients often do not have a palpable breast mass because there is actually a low volume of breast cancer.
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