Presentation
Diagnostic mammography. Stiffness, induration, and erythema of the right breast for two months without responding to antibiotic therapy.
Patient Data
The right breast is relatively small and shows skin thickening and parenchymal edema. An obscured mass-like density is present in the upper central part of the right breast, causing nipple retraction.
Foci of calcifications with a benign appearance are scattered in both breasts.
Several small masses with partially obscured margins, without internal calcification and surrounding parenchymal distortion, are observed in the left breast. There is no evidence in favor of retraction and skin thickening in this area.
In the visualized mammography field, the lymph node with a suspected pathological appearance is not seen in the axillary regions.
Case Discussion
The patient underwent a targeted ultrasonography and ultrasound-guided core needle biopsy of the mentioned right breast obscured mass-like lesion. The histopathology and IHC evaluation confirmed invasive breast carcinoma of no special type. Neo-adjuvant chemotherapy and then right mastectomy with axillary lymphadenectomy were performed. Finally, the patient went to have post-surgical chemoradiotherapy.
Inflammatory breast carcinoma is a relatively uncommon but aggressive form of invasive breast carcinoma with a characteristic clinical presentation and unique radiographic appearances. Clinically and in imaging inflammatory breast cancer mimics mastitis.
Any subtype of primary breast carcinoma can cause inflammatory breast carcinoma, and dermal lymphatic invasion is the keypoint and pathognomonic for diagnosis. Regarding dermal lymphatic invasion, inflammatory breast cancer is a T4 tumor according to the standard TNM staging classification of breast cancer.
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