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Review
. 2022 Apr;192(2):235-243.
doi: 10.1007/s10549-021-06434-x. Epub 2022 Jan 1.

Inflammatory breast cancer defined: proposed common diagnostic criteria to guide treatment and research

R Jagsi  1 , G Mason  2   3 , B A Overmoyer  4 , W A Woodward  5 , S Badve  6 , R J Schneider  7 , J E Lang  8 , M Alpaugh  9 , K P Williams  10 , D Vaught  11 , A Smith  11 , K Smith  11 , K D Miller  12 ; Susan G. Komen-IBCRF IBC Collaborative in partnership with the Milburn Foundation
Affiliations
Review

Inflammatory breast cancer defined: proposed common diagnostic criteria to guide treatment and research

R Jagsi et al. Breast Cancer Res Treat. 2022 Apr.

Erratum in

Abstract

Purpose: Inflammatory breast cancer is a deadly and aggressive type of breast cancer. A key challenge relates to the need for a more detailed, formal, objective definition of IBC, the lack of which compromises clinical care, hampers the conduct of clinical trials, and hinders the search for IBC-specific biomarkers and treatments because of the heterogeneity of patients considered to have IBC.

Methods: Susan G. Komen, the Inflammatory Breast Cancer Research Foundation, and the Milburn Foundation convened patient advocates, clinicians, and researchers to review the state of IBC and to propose initiatives to advance the field. After literature review of the defining clinical, pathologic, and imaging characteristics of IBC, the experts developed a novel quantitative scoring system for diagnosis.

Results: The experts identified through consensus several "defining characteristics" of IBC, including factors related to timing of onset and specific symptoms. These reflect common pathophysiologic changes, sometimes detectable on biopsy in the form of dermal lymphovascular tumor emboli and often reflected in imaging findings. Based on the importance and extent of these characteristics, the experts developed a scoring scale that yields a continuous score from 0 to 48 and proposed cut-points for categorization that can be tested in subsequent validation studies.

Conclusion: To move beyond subjective 'clinical diagnosis' of IBC, we propose a quantitative scoring system to define IBC, based on clinical, pathologic, and imaging features. This system is intended to predict outcome and biology, guide treatment decisions and inclusion in clinical trials, and increase diagnostic accuracy to aid basic research; future validation studies are necessary to evaluate its performance.

Keywords: Clinical diagnosis; Diagnostic criteria; Inflammatory breast cancer; Molecular markers; Pathology.

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Conflict of interest statement

The authors declare that there are no conflict of interest or competing interests relating to the present work (although some receive grants for unrelated work from the Komen Foundation, which funded the current work).

Figures

Fig. 1
Fig. 1
Clinical characteristics of Inflammatory Breast Cancer. Clinical characteristics and variations of established conditions to support the diagnosis of Inflammatory Breast Cancer as measured by the proposed scoring system
Fig. 2
Fig. 2
Pathologic characteristics for Inflammatory Breast Cancer. Variations of the pathologic presentation of lymphatic emboli, represented in H&E tissue staining, to support the diagnosis of Inflammatory Breast Cancer as measured by the proposed scoring system
Fig. 3
Fig. 3
Imaging characteristics of Inflammatory Breast Cancer. Variations of the breast imaging to support the diagnosis of Inflammatory Breast Cancer as measured by the proposed scoring system
See this image and copyright information in PMC

References

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