MAMMOGRAPHIC PATTERNS OF INFLAMMATORY BREAST-CARCINOMA - A RETROSPECTIVE STUDY OF 92 CASES

Objective: To quantitate initial mammographic signs and to describe po st-therapeutic patterns of inflammatory breast cancer. Material and me thods: Two radiologists retrospectively analyzed the initial clinical and mammographic findings of 92 patients with inflammatory breast carc inoma. The post-therapeutic mammogram (n = 75) was considered abnormal when focal opacity and/or malignant-type microcalcifications were sti ll visible. Results: Redness of the skin, 'peau d'orange' and increase d temperature were the most common findings. A palpable mass was noted in 97% with axillary lymph node involvement in 83% of cases. All init ial mammograms were abnormal. Isolated inflammatory signs were observe d in 14% and malignant signs in 86% of patients (opacity = 77% and/or malignant-type microcalcifications = 47%). Skin thickening was seen in 93.5%, nipple inversion in 56.5%, increased breast density in 93.5%, stromal coarsening in 85% and hypervascularisation in 32.5% of mammogr ams. On post-therapeutic mammograms, 35 patients (46.5%) were suspecte d of having residual disease. During follow-up, 19 patients (25.3%) re lapsed locally: 75% had abnormal post-therapeutic mammograms. Conclusi on: The presence of isolated inflammatory signs on the mammogram is su fficient to suspect inflammatory breast carcinoma and biopsy must be p erformed in doubtful cases. Radical surgery is indicated when persiste nt malignant signs are still visible on mammogram after conservative t reatment. (C) 1997 Elsevier Science Ireland Ltd.