2017 Volume 79 Issue 5 Pages 487-491
A 61-year-old woman with cancer of the right breast presented with diffuse erythema on her right breast during preoperative chemotherapy. Histopathological assessment of the erythema indicated no invasion of breast cancer cells ;therefore, treatment with topical steroid was conducted. One month later, radical right mastectomy and right axillary lymph node dissection were performed. During postoperative ionizing radiotherapy, the erythema spread over the upper abdomen and left chest, i.e., on the opposite side to the primary lesion. Histopathology of the erythematous papules revealed tumor cells in the lymphatic vessels and the diagnosis of inflammatory breast cancer (IBC) was made. Although chemotherapy initially improved the erythema, diffuse annular erythema later reappeared on her left breast. Histopathological and positron emission tomography/computed tomography examinations indicated a relapse of the IBC, and the chemotherapy was restarted. The erythema disappeared 6 months later and she has been doing well until now at over 4 years since the initial diagnosis of mammary cancer. IBC is a rare condition that is defined as a form of breast cancer with symptoms of swelling and reddening of the skin. The histologic hallmark of IBC is cancer cell emboli in the dermal lymphatic vessels. In the present case, we consider that embolic cancer cells invaded over the midline of the trunk through interconnecting lymphatic vessels to develop skin lesions in the contralateral breast. If patients with breast cancer develop inflammatory cutaneous symptoms, IBC should be suspected.
