Mammography, Ultrasonography and Inflammatory Breast Cancer

A finding of skin thickening determined by mammography or ultrasonography should be seen as a diagnostic suspicion of inflammatory breast cancer.

Diffuse mammographic abnormalities such as skin thickening, increased density, trabecular thickening, and axillary lymphadenopathy are common at presentation in patients with primary inflammatory carcinoma of the breast. Mammographic masses and malignant-appearing calcifications are uncommon manifestations of this disease.” “The mammographic characteristics of inflammatory carcinoma of the breast identified in this study were diffuse and often subtle. Skin thickening and diffusely increased density were the most common findings, seen in 92% and 81% of patients, respectively. In most cases, proper use of a mask and a bright light was necessary to detect skin thickening as well as trabecular thickening and nipple retraction.

Citation: Kushwaha, Anne C., Gary J. Whitman, et al. “Primary Inflammatory Carcinoma of the Breast: retrospective review of mammographic findings.” American Journal of Roentgenology. 174.2 (2000): 535-38. Web. retrieved 22 May 2012.
http://www.ajronline.org/doi/abs/10.2214/ajr.174.2.1740535

Ultrasound, when compared with mammography, more commonly demonstrated skin thickening, which is an important finding in the diagnosis of inflammatory carcinoma.

“Presence of isolated inflammatory signs is sufficient to suggest inflammatory breast carcinoma clinically. Inflammatory breast carcinoma has a mammographic pattern of inflammatory changes, such as skin thickening and stromal coarsening and/or diffusely increased breast density with or without an associated mass and/or malignant-type microcalcifications. US is helpful not only in depiction of masses masked by the edema pattern but also in demonstration of skin and pectoral muscle invasion and axillary involvement.”

Citation: Gunhan-Bilgen, Isil, Esin Emin Ustun, and Aysenur Memis. “Inflammatory breast carcinoma: mammographic, ultrasonographic, clinical, and pathologic findings in 142 cases.” Radiology. 223.3 (2002): 829-38. Web. retrieved 14 Apr 2014.
http://pubs.rsna.org/doi/abs/10.1148/radiol.2233010198

See also Symptoms of IBC and Photos of IBC.