Inflammatory Breast Cancer

Inflammatory breast cancer accounts for 2% to 6% of all breast cancer cases in the United States. Although it is relatively rare, it is the most lethal form of breast cancer. Inflammatory breast cancer is characterized by rapid onset of diffuse erythema and/or peau d’orange. The affected breast often becomes enlarged and warm to the touch. The disease can be difficult to identify because a palpable breast mass is often absent on physical examination. Mammograms of women with inflammatory breast cancer often show architectural distortion and skin thickening. Most women with inflammatory breast cancer also have regional lymph node metastases at initial presentation that can be seen via ultrasound. Biopsies are needed to confirm the presence of invasive breast cancer. Confirmed cases of inflammatory breast cancer are treated with trimodal therapy which includes primary systemic chemotherapy, surgery, and radiotherapy. Primary systemic chemotherapy is used to downgrade the tumor and make the area operable with the goal of obtaining negative margins after surgery. Chemotherapy should consist of a taxane and anthracycline. Hormonal therapy and targeted therapies may also be used depending on the tumor expression. Pharmacists can help improve survival for this devastating disease by recommending appropriate treatment options and discussing potential toxicities with the healthcare professional team.