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Inflammatory breast cancer and the importance of skin punch biopsy

Published:November 11, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.11.017

      Highlights

      • 71% of patients diagnosed with IBC had a skin punch biopsy positive for dermal lymphatic invasion.
      • Patients with IBC had a 26% incidence of triple negative and 40% HER 2 positive tumor biology.
      • Patients with a positive skin biopsy had a significantly higher incidence of a chest wall recurrence.
      • Overall 5 year survival was 61% with no difference in survival for those with a positive skin biopsy.

      Abstract

      Background

      The oncologic outcomes of patients diagnosed with inflammatory breast cancer (IBC) based on clinical exam only versus those with dermal lymphatic invasion on skin punch biopsy may be different and are worth further investigation.

      Methods

      Patients diagnosed from 2006 to 2021 with IBC at our institution were grouped according to clinical diagnosis or skin biopsy performed. Oncologic and survival outcomes among groups were compared.

      Results

      A total of 72 IBC patients were identified and grouped into 3 categories based on method of diagnosis: skin biopsy positive (n = 24), skin biopsy negative (n = 10) and no biopsy performed (n = 38). Skin biopsy positive patients had a higher incidence of lymphovascular invasion identified on final pathology and were more likely to experience a chest wall recurrence. At 5.1 yrs of follow-up, 40% of patients experienced recurrence, with 61% overall survival.

      Conclusion

      Clinical diagnosis remains diagnostic for IBC, but skin punch biopsy allows for improved oncologic insight.

      Keywords

      Abbreviations:

      Inflammatory Breast Cancer (IBC), Skin Punch Biopsy (SPB), Dermal Lymphatic Invasion (DLI), Locally Advanced Breast Cancer (LABC)
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