Inflammatory breast carcinoma: Pathological or clinical entity ?

Inflammatory breast carcinoma (IBC) diagnosis is usually based in the prese nce of typical clinical symptoms (redness and edema in more than 2/3 of the breast), which are not always associated with pathologic characteristics ( subdermal lymphatics involvement). Whether exclusively pathologic findings without clinical symptoms are sufficient for IBC diagnosis remains controve rsial. A retrospective analysis of 163 clinically diagnosed IBC (CIC) eithe r with dermal lymphatics invasion or not, was compared with another group o f 99 patients with dermal lymphatics invasion without clinical symptoms (oc cult inflammatory carcinoma) (OIC). The following clinical and pathological characteristics have been analyzed and compared: age, menopausal status, c linical axillar node involvement, symptoms duration before diagnosis, grade , estrogen receptors, presence of metastases at diagnosis, local recurrence , metastasic dissemination, disease-free (DFS) and overall survival (OS). M edian age was younger in CIC (52.3 vs. 63.8 years; p < 0.001). Symptom dura tion before diagnosis were significantly shorter in CIC (3.4 vs. 6.8 months ; p < 0.0001). Visceral (36.2% vs. 17.2%; p = 0.001) and brain metastases ( 7.4% vs. 1%; p = 0.02) was significantly more frequent in CIC. Negative est rogen receptors were more frequent in CIC (34.9% vs. 65.1%; p < 0.004). Fiv e-years DFS (25.6 vs. 51.6%; p < 0.0001) and OS (28.6 vs. 40%; p < 0.05) we re shorter in CIC. CIC (regardless of subdermal lymphatics involvement) mus t be clearly differentiated from OIC. Prognosis of CIC patients is poorer, so this two entities should be clearly differentiated when therepeutic resu lts are reported.