Inflammatory breast cancer
ICD-10 C50.9 · ICD-11 2C62

First-Line Treatment of Inflammatory Breast Cancer

Inflammatory breast cancer (IBC) is an aggressive presentation that requires a structured, combined-modality approach beginning at diagnosis. Preoperative systemic therapy, surgery, and radiotherapy are coordinated from the outset, with regimen selection guided by tumor biology.

Treatment Approach

Management starts with preoperative (neoadjuvant) systemic chemotherapy built around an anthracycline-based backbone. The specific regimen is shaped by receptor status — HER2-positive disease calls for inclusion of targeted therapy in the preoperative plan. The complete regimen, options, and sequencing are detailed in the full protocol.

Clinical Response Goals

Treatment success is assessed by reduction of the in-breast tumor and regression of the characteristic skin findings: erythema, edema, and peau d'orange. Response evaluation combines physical examination with appropriate imaging of sites that were abnormal at initial staging.

Instant Access to Structured Evidence-Based Regimens

References

  1. The treatment of patients with IBC should involve a combined modality approach comprising preoperative systemic therapy followed by surgery (mastectomy) and radiotherapy.
  2. The NCCN Panel recommends preoperative systemic therapy with an anthracycline-based regimen with or without taxanes for the initial treatment of patients with IBC.
  3. The NCCN Panel recommends inclusion of trastuzumab in the chemotherapy regimen and is recommended for patients with HER2-positive disease.
  4. A pertuzumab-containing regimen may be administered preoperatively to patients with HER2-positive IBC.
  5. The accurate assessment of in-breast tumor or regional lymph node response to preoperative systemic therapy is difficult, and should include physical examination and performance of imaging studies (mammogram and/or breast ultrasound and/or breast MRI) that were abnormal at the time of initial tumor staging.
View source ↗