Inflammatory breast cancer: early recognition and diagnosis is critical

Am J Obstet Gynecol. 2021 Oct;225(4):392-396. doi: 10.1016/j.ajog.2021.04.217. Epub 2021 Apr 20.


Inflammatory breast cancer is a rare and aggressive malignancy that is often initially misdiagnosed because of its similar presentation to more benign breast pathologies such as mastitis, resulting in treatment delays. Presenting symptoms of inflammatory breast cancer include erythema, skin changes such as peau d' orange or nipple inversion, edema, and warmth of the affected breast. The average age at diagnosis is younger than in noninflammatory breast cancer cases. Known risk factors include African American race and obesity. Diagnostic criteria include erythema occupying at least one-third of the breast, edema, peau d' orange, and/or warmth, with or without an underlying mass; a rapid onset of <3 months; and pathologic confirmation of invasive carcinoma. Treatment of inflammatory breast cancer includes trimodal therapy with chemotherapy, surgery, and radiation. An aggressive surgical approach that includes a modified radical mastectomy enhances survival outcomes. Although the outcomes for patients with inflammatory breast cancer are poor compared with those of patients with noninflammatory breast cancer, patients with inflammatory breast cancer who complete trimodal therapy have a favorable locoregional control rate, underscoring the importance of a prompt diagnosis of this serious but treatable disease. Obstetrician-gynecologists and other primary care providers must recognize the signs and symptoms of inflammatory breast cancer to make a timely diagnosis and referral for specialized care.

Keywords: IBC diagnosis; breast erythema; inflammatory breast cancer; mastitis; peau d’ orange; trimodality therapy; tumor emboli.

Publication types

  • Review

MeSH terms

  • Alcohol Drinking / epidemiology
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Axilla / surgery
  • Black or African American / statistics & numerical data
  • Chemoradiotherapy, Adjuvant*
  • Contraceptives, Oral / therapeutic use
  • Diagnosis, Differential
  • Early Diagnosis
  • Early Medical Intervention
  • Granulomatous Mastitis / diagnosis
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Inflammatory Breast Neoplasms / diagnosis
  • Inflammatory Breast Neoplasms / epidemiology
  • Inflammatory Breast Neoplasms / pathology
  • Inflammatory Breast Neoplasms / therapy*
  • Lymph Node Excision*
  • Mastectomy, Modified Radical*
  • Mastitis / diagnosis
  • Neoadjuvant Therapy*
  • Neoplasm Staging
  • Obesity / epidemiology
  • Risk Factors
  • White People / statistics & numerical data


  • Antineoplastic Agents, Hormonal
  • Antineoplastic Agents, Immunological
  • Contraceptives, Oral