HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Günhan-Bilgen, I. Articles by Memis, A. Search for Related Content PubMed PubMed Citation Articles by Günhan-Bilgen, I. Articles by Memis, A.

Inflammatory Breast Carcinoma: Mammographic, Ultrasonographic, Clinical, and Pathologic Findings in 142 Cases¹

Iil Günhan-Bilgen, MD, Esin Emin Üstün, MD and Ayenur Memi, MD

¹ From the Department of Radiology, Ege University Hospital, Bornova, 35100 Izmir, Turkey. Received December 21, 2000; revision requested February 16, 2001; final revision received November 27; accepted December 19. Address correspondence to I.G.B. (e-mail: isilbilgen@hotmail.com).

View larger version (81K): [in a new window]   Figure 1. Craniocaudal mammogram obtained in a 58-year-old woman with a palpable mass in the right breast. The left breast was normal. A spiculated mass (arrowheads) is seen in the right breast. Neither radiologic findings nor a clinical pattern of inflammatory carcinoma was present. However, tumor emboli in the dermal lymphatics were detected at the histopathologic examination of the surgical specimen removed at mastectomy, and on the basis of these findings, a diagnosis of inflammatory breast carcinoma was determined. Histologic subtype and size: invasive ductal carcinoma, 3.4 cm in longest diameter.

View larger version (111K): [in a new window]   Figure 2a. Images obtained in a 64-year-old woman with a mass 6 cm in longest diameter in the upper outer quadrant of the left breast, peau d’orange, and nipple retraction. (a) Craniocaudal mammogram of the left breast shows diffuse skin thickening (arrowheads), trabecular coarsening, and a spiculated mass (arrows) 5.5 cm in longest diameter in the outer quadrant. (b) Transverse US scans show marked skin thickening (*) and dilated lymphatic channels (arrows) that are typical of the breast edema pattern. Hypoechoic masses are also seen. Histologic subtype and size: invasive ductal carcinoma, 6 cm in longest diameter.

View larger version (67K): [in a new window]   Figure 2b. Images obtained in a 64-year-old woman with a mass 6 cm in longest diameter in the upper outer quadrant of the left breast, peau d’orange, and nipple retraction. (a) Craniocaudal mammogram of the left breast shows diffuse skin thickening (arrowheads), trabecular coarsening, and a spiculated mass (arrows) 5.5 cm in longest diameter in the outer quadrant. (b) Transverse US scans show marked skin thickening (*) and dilated lymphatic channels (arrows) that are typical of the breast edema pattern. Hypoechoic masses are also seen. Histologic subtype and size: invasive ductal carcinoma, 6 cm in longest diameter.

View larger version (96K): [in a new window]   Figure 3a. Images obtained in a 66-year-old woman with a palpable mass in the upper quadrant of the left breast and breast erythema. The right breast was normal. (a) Mediolateral oblique mammogram of the left breast shows trabecular thickening (arrows), a spiculated mass (*) 1.5 cm in longest diameter, and diffuse pleomorphic microcalcifications suggestive of malignancy. Round axillary nodes (arrowheads) with increased density and loss of lucent fatty hilum are consistent with axillary lymphadenopathy. (b) Pleomorphic microcalcifications (arrowheads) are better seen on the close-up image (photographic enlargement). (c) Transverse US scans show that the mass (thick arrow) with irregular contour has invaded the skin (thin arrows). Findings at histopathologic examination of the surgical specimen removed at mastectomy confirmed direct dermal invasion. Histologic subtype and size: invasive ductal carcinoma, 1.7 cm in longest diameter.

View larger version (117K): [in a new window]   Figure 3b. Images obtained in a 66-year-old woman with a palpable mass in the upper quadrant of the left breast and breast erythema. The right breast was normal. (a) Mediolateral oblique mammogram of the left breast shows trabecular thickening (arrows), a spiculated mass (*) 1.5 cm in longest diameter, and diffuse pleomorphic microcalcifications suggestive of malignancy. Round axillary nodes (arrowheads) with increased density and loss of lucent fatty hilum are consistent with axillary lymphadenopathy. (b) Pleomorphic microcalcifications (arrowheads) are better seen on the close-up image (photographic enlargement). (c) Transverse US scans show that the mass (thick arrow) with irregular contour has invaded the skin (thin arrows). Findings at histopathologic examination of the surgical specimen removed at mastectomy confirmed direct dermal invasion. Histologic subtype and size: invasive ductal carcinoma, 1.7 cm in longest diameter.

View larger version (105K): [in a new window]   Figure 3c. Images obtained in a 66-year-old woman with a palpable mass in the upper quadrant of the left breast and breast erythema. The right breast was normal. (a) Mediolateral oblique mammogram of the left breast shows trabecular thickening (arrows), a spiculated mass (*) 1.5 cm in longest diameter, and diffuse pleomorphic microcalcifications suggestive of malignancy. Round axillary nodes (arrowheads) with increased density and loss of lucent fatty hilum are consistent with axillary lymphadenopathy. (b) Pleomorphic microcalcifications (arrowheads) are better seen on the close-up image (photographic enlargement). (c) Transverse US scans show that the mass (thick arrow) with irregular contour has invaded the skin (thin arrows). Findings at histopathologic examination of the surgical specimen removed at mastectomy confirmed direct dermal invasion. Histologic subtype and size: invasive ductal carcinoma, 1.7 cm in longest diameter.

View larger version (95K): [in a new window]   Figure 4a. Images obtained in a 47-year-old woman with peau d’orange. (a) Craniocaudal mammogram of the right breast shows skin thickening (arrows), parenchymal edema, and focal asymmetric density (*) in the outer quadrant. At US, a solid mass 3 cm in longest diameter with irregular contour was seen in this location. (b) Craniocaudal mammogram of the left breast is normal. (c) Transverse US scans of the lower inner quadrant of the right breast show marked skin thickening (*), dilated lymphatic channels (arrowheads), and focal areas of parenchymal acoustic shadowing (arrows). Histologic subtype and size: invasive ductal carcinoma, 3.3 cm in longest diameter.

View larger version (113K): [in a new window]   Figure 4b. Images obtained in a 47-year-old woman with peau d’orange. (a) Craniocaudal mammogram of the right breast shows skin thickening (arrows), parenchymal edema, and focal asymmetric density (*) in the outer quadrant. At US, a solid mass 3 cm in longest diameter with irregular contour was seen in this location. (b) Craniocaudal mammogram of the left breast is normal. (c) Transverse US scans of the lower inner quadrant of the right breast show marked skin thickening (*), dilated lymphatic channels (arrowheads), and focal areas of parenchymal acoustic shadowing (arrows). Histologic subtype and size: invasive ductal carcinoma, 3.3 cm in longest diameter.

View larger version (105K): [in a new window]   Figure 4c. Images obtained in a 47-year-old woman with peau d’orange. (a) Craniocaudal mammogram of the right breast shows skin thickening (arrows), parenchymal edema, and focal asymmetric density (*) in the outer quadrant. At US, a solid mass 3 cm in longest diameter with irregular contour was seen in this location. (b) Craniocaudal mammogram of the left breast is normal. (c) Transverse US scans of the lower inner quadrant of the right breast show marked skin thickening (*), dilated lymphatic channels (arrowheads), and focal areas of parenchymal acoustic shadowing (arrows). Histologic subtype and size: invasive ductal carcinoma, 3.3 cm in longest diameter.

View larger version (92K): [in a new window]   Figure 5a. Images obtained in a 50-year-old woman with a subareolar mass 4 cm in longest diameter. The right breast was normal. (a) Craniocaudal mammogram of the left breast shows skin thickening that was seen with bright light (not seen on the image) and a mass (*). The anterior contour of the mass (arrows) is obscured by the fibroglandular tissue opacities; the posterior contour shows irregularity. (b) Transverse US scans show two solid masses (arrows) with irregular contours in the subareolar region, which is consistent with multifocal carcinoma. Histologic subtypes and sizes: invasive ductal carcinoma and multifocal carcinoma, 4.5 and 0.7 cm in longest diameter, respectively.

View larger version (99K): [in a new window]   Figure 5b. Images obtained in a 50-year-old woman with a subareolar mass 4 cm in longest diameter. The right breast was normal. (a) Craniocaudal mammogram of the left breast shows skin thickening that was seen with bright light (not seen on the image) and a mass (*). The anterior contour of the mass (arrows) is obscured by the fibroglandular tissue opacities; the posterior contour shows irregularity. (b) Transverse US scans show two solid masses (arrows) with irregular contours in the subareolar region, which is consistent with multifocal carcinoma. Histologic subtypes and sizes: invasive ductal carcinoma and multifocal carcinoma, 4.5 and 0.7 cm in longest diameter, respectively.

View larger version (82K): [in a new window]   Figure 6a. Images in a 60-year-old woman with peau d’orange and a subareolar mass 3 cm in longest diameter. (a) Initial craniocaudal mammogram of the left breast shows skin thickening (arrowheads) and diffuse increased density. Biopsy of the skin disclosed inflammatory carcinoma. (b) Transverse US scans, obtained at the same time, depict a mass (arrow) 4 cm in longest diameter with irregular contour in the subareolar region. (c) Craniocaudal mammogram of the same breast 1 year after neoadjuvant chemotherapy shows that the pattern of edema regressed substantially, although there is still some skin thickening (arrowheads). No mass was depicted at US. Findings at histopathologic examination of the specimen removed at mastectomy showed that the invasive component of the tumor had totally resolved and had left behind only fibrosis and in situ foci.

View larger version (137K): [in a new window]   Figure 6b. Images in a 60-year-old woman with peau d’orange and a subareolar mass 3 cm in longest diameter. (a) Initial craniocaudal mammogram of the left breast shows skin thickening (arrowheads) and diffuse increased density. Biopsy of the skin disclosed inflammatory carcinoma. (b) Transverse US scans, obtained at the same time, depict a mass (arrow) 4 cm in longest diameter with irregular contour in the subareolar region. (c) Craniocaudal mammogram of the same breast 1 year after neoadjuvant chemotherapy shows that the pattern of edema regressed substantially, although there is still some skin thickening (arrowheads). No mass was depicted at US. Findings at histopathologic examination of the specimen removed at mastectomy showed that the invasive component of the tumor had totally resolved and had left behind only fibrosis and in situ foci.

View larger version (94K): [in a new window]   Figure 6c. Images in a 60-year-old woman with peau d’orange and a subareolar mass 3 cm in longest diameter. (a) Initial craniocaudal mammogram of the left breast shows skin thickening (arrowheads) and diffuse increased density. Biopsy of the skin disclosed inflammatory carcinoma. (b) Transverse US scans, obtained at the same time, depict a mass (arrow) 4 cm in longest diameter with irregular contour in the subareolar region. (c) Craniocaudal mammogram of the same breast 1 year after neoadjuvant chemotherapy shows that the pattern of edema regressed substantially, although there is still some skin thickening (arrowheads). No mass was depicted at US. Findings at histopathologic examination of the specimen removed at mastectomy showed that the invasive component of the tumor had totally resolved and had left behind only fibrosis and in situ foci.