1924: Burton J. Lee and Norman E. Tannenbaum introduced the term “inflammatory breast cancer (IBC)” and considered it a distinct entity
“Inflammatory carcinoma of the breast: a report of twenty-eight cases from the breast clinic of the Memorial Hospital” Lee BJ, Tannenbaum NE, Surg Gynecol Obstet 1924;39-580-95
“Inflammatory carcinoma of the female breast presents such unusual clinical manifestations that they are often misinterpreted by the physician who is first consulted. The object of this paper is to give a clear description of “inflammatory carcinoma of the breast,” in order that this unusual phase of carcinoma of the mammary gland may be better recognized by physicians generally and by surgeons and radiologists particularly.“
“Several times we have presented cases of inflammatory carcinoma before surgical societies, but apparently have failed to convince our audiences that these inflammatory symptoms were truly cancerous in nature.“
Prior to this paper in 1924, the authors wrote, “Examples of this unusual type of mammary cancer have been described by numerous observers, but with variations in terminology suggesting the uncertainty which exists concerning the true nature of this process.” They add, “All observers have focused their attention upon the pathology of the breast tumor itself, but have failed to recognize the significance of the erysipelatous involvement of the skin.” Terminology they list includes:
- “Mastitis carcinomatosa,” Volkmann in 1875.
- “Carcinoma mastitoides” and “acute mammary carcinoma,” Schumann* (1911) and Learnmouth* (1916).
- “Acute carcinoma of the breast, ” Rodman* (1908) and Leitch (1911).
- “Lymphocytoma of the breast,” Lardennois and Moure* in 1914.
- “Lactation cancer,” “acute medullary carcinoma,” “acute encephaloid carcinoma,” “inflamed cancer,” “acute brawny cancer,” and “acute scirrhous carcinoma,” attribution for these terms was not given by Lee and Tannenbaum.
“A considerable number of the patients are young women, in our series, 10, or 35.79 per cent, being 39 years or under. The youngest patient was 24, the oldest 62, and the average for the entire group was 44.6 years.“
Note: In 1929 (statistic for 1924 not available), the average life expectancy for women (all races) was 58.7 years (60.3 years for white, and 47.8 years for black); in 1997 the life expectancies were 79.4, 79.9, and 74.7 years, respectively.
“In only 2 of the cases was there any definite history of trauma to the breast. Hence, the inflammatory phase cannot be interpreted as in any sense traumatic in origin.“
Note: Contrast this with the report in Chamadol, et al. 1987, of a non-menstruating 12-year old girl diagnosed with inflammatory breast cancer two months after being struck by a football in her left breast.
“Except in a few instances neither mastectomy nor biopsy has been done; hence we are unable to report fully the pathology of the breast tumor. In the recurrent cases few pathological reports or slides have been furnished by the hospitals in which the operation was performed, although every effort has been made to obtain them. The findings vary from comedocarcinoma, carcinoma simplex, mammary carcinoma invading dermal lymphatics, and large alveolar carcinoma to scirrhous carcinoma.“
“The marked variation in the pathological findings raises the questions: Is one justified in including these inflammatory carcinomata in a single group? Is it not possible that some additional factor has been added to account for the inflammatory manifestations?“
“In a few cases, a study of the material obtained through areas of skin invasion shows dermal lymphatics everywhere invaded by carcinoma cells. This diffuse lymphatic metastasis is the most distinctive microscopic pathological feature of this phase of mammary carcinoma.“
The authors’ conclusions, in 1924, are:
“Inflammatory carcinoma appears to be a distinct clinical phase of carcinoma of the breast.”
“Generally, this type has been unrecognized, being frequently mistaken for other diseases of the breast.”
“The inflammatory appearances are characteristic.”
“This variety of mammary cancer shows no constant pathological type.”
“The most striking pathological change is a wide invasion of dermal lymphatics by carcinoma.”
“Bacteriological and biochemical studies have failed to explain the inflammatory manifestations.”
“The cases do badly if treated surgically.”
“At present radiation offers the only hope of palliation, diminishing the patient’s suffering, and giving a definite prolongation of life.“
* Citations for those authors not included on this page
Schumann, EA, Carcinoma Mastitoides; Ann Surg, 1911, liv, 69-77.
Learnmouth, GE, Acute mammary carcinoma; Canadian M. Ass. J., 1916 vi, 499-511.
Rodman, WL, Diseases of the Breast; Philadelphia: 1908, 226-228.
Lardennois, M., Moure, P., Lymphocytoma du Sein. Bull, Soc. anat. de Par., 1914, lxxxix, 94-103.
