Tratamiento radiante adyuvante del lecho quirúrgico en el cáncer de mama: a quién, cuándo y cómo hacerlo: Revisión narrativa / Adjuvant radiation treatment of the surgical bed in breast cancer: who, when and how to do it: A narrative review

Introducción: Actualmente existen discrepancias en cuanto a la indicación, dosis, técnica y contorneo de la sobreimpresión o aumento de dosis de irradiación sobre el lecho quirúrgico en el trata-miento adyuvante en cáncer de mama. Propósito de la revisión: El objetivo de la revisión es presentar la evidencia disponible en sobre-impresión del lecho quirúrgico en el tratamiento de cáncer de mama. Realizamos una revisión bibliográfica en MEDLINE pubmed, se analizaron 61 estudios publicados entre enero del 2000 a enero del 2022. Recientes hallazgos: La sobreimpresión sobre el lecho quirúrgico en la mama mejora el control local en aquellas pacientes con elementos de alto riesgo. Las diferentes técnicas disponibles son oncológicamente equivalentes. La delimitación del blanco de tratamiento debe guiarse por los clips quirúrgicos. Conclusiones: La indicación de dicho tratamiento deberá ser evaluado por los servicios de oncología radioterápica, definiendo sus protocolos y algoritmos de acción.

Introduction: Currently, there are discrepancies regarding the indication, dose, technique, and con-touring of the super impression or increase in irradiation dose on the surgical bed in adjuvant treatment in breast cancer. Purpose of the review: The objective is to present evidence on superimposing the surgical bed to treat breast cancer. We conducted a bibliographic review in MEDLINE PubMed; 61 studies published between January 2000 and January 2022 were analyzed. Recent findings: Superimpression of the surgical bed in the breast improves local control in patients with high-risk elements. The different techniques available are oncologically equivalent, and the surgical clips should guide the delineation of the treatment target. Conclusions: The indication of this treatment must be evaluated by radiotherapy oncology services, defining their protocols and action algorithms.

Multi-center investigation of the clinical and pathological characteristics of inflammatory breast cancer based on Chinese Society of Breast Surgery (CSBrs-007) / 中华医学杂志(英文版)

BACKGROUND@#Inflammatory breast cancer (IBC) is an aggressive type of cancer with poor prognosis and outcomes. This study aimed to investigate clinicopathological features, molecular characteristics, and treatments among Chinese patients diagnosed with IBC.@*METHODS@#We collected data of 95 patients with IBC who were treated by members of the Chinese Society of Breast Surgery, from January 2017 to December 2018. The data, including demographic characteristics, pathological findings, surgical methods, systemic treatment plans, and follow-up, were obtained using a uniform electronic questionnaire. The clinicopathological features of different molecular types in patients without distant metastases were compared using the Kruskal-Wallis (H) test followed by post hoc analyses.@*RESULTS@#Lymph node metastasis was noted in 75.8% of all patients, while distant metastasis was noted in 21.4%. Pathological findings indicated invasive ductal and lobular carcinomas in 86.8% and 5.3% of cases, respectively. Hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) (41.5%) and HR-/HER2+ (20.1%) were the most common biologic subtypes, followed by HR+/HER2+ (19.1%) and HR-/HER2- (19.1%). Stage III IBC was treated via pre-operative neoadjuvant chemotherapy in 87.7% of the cases, predominantly using anthracycline and taxanes. A total of 91.9% of patients underwent surgical treatment. Among them, 77.0% of the patients underwent modified radical mastectomy, 8.1% of whom also underwent immediate breast reconstruction. The Kruskal-Wallis test revealed that the efficacy of chemotherapy significantly differed among those with HR+/HER2- and HR-/HER2- tumors (adjusted P = 0.008), and Ki-67 expression significantly differed in HR-/HER2+ and HR+/HER2+ molecular subtypes (adjusted P = 0.008).@*CONCLUSION@#Our study provides novel insight into clinicopathological characteristics and treatment status among patients with IBC in China, and might provide a direction and basis for further studies.@*TRIAL REGISTRATION@#chictr.org.cn, No. ChiCTR1900027179; http://www.chictr.org.cn/showprojen.aspx?proj=45030.

Incidence of human cytomegalovirus in breast carcinoma tissues is associated with a higher expression of growth factor receptor-bound protein 2

Background: female mammary carcinoma is the second most common cancer incidence among women and the fifth most common leading cause of cancer death worldwide. Premenopausal young women are more frequently targeted by inflammatory breast cancer (IBC), which is the most lethal form of breast cancer. The human cytomegalovirus (HCMV) has been identified as one of the viral infection with a higher frequency in carcinoma tissues of IBC than in non-IBC. The adaptor protein growth factor receptor-bound protein 2 (Grb2), was found to be upregulated in HCMV-infected cells and play as crucial role in cancer progression. Objective: this study aimed to assess the expression level of Grb2 in carcinoma tissues of IBC and non-IBC with HCMV infection. Patients and Methods: overall, 135 female diagnosed with breast carcinoma were enrolled in this study. Using conventional and real time polymerase chain reaction (PCR), we determined the incidence of HCMV and assessed the expression level of Grb2 mRNA in the breast cancer tissue samples. Results: Grb2 mRNA was significantly upregulated in HCMV+ IBC higher than in HCMV+ non-IBC. According to the molecular subtype, Grb2 mRNA was significantly higher upregulated in breast carcinoma tissues of HCMV+ hormonal positive (HP) than in triple negative (TN) counterparts. Conclusion: HCMV infection is associated with a high expression of Grb2 mRNA in IBC and that HP HCMV+ mammary carcinoma tissues confer upregulated Grb2 mRNA, suggesting a potential role of HCMV infection in enhancing of Grb2 mRNA expression in breast cancer with HP

Single vertical incision thoracoabdominal flap for chest wall reconstruction following mastectomy of locally advanced breast cancer

PURPOSE: Skin grafts have been widely used in managing extensive chest wall defects after mastectomy for advanced breast cancer. However, their durability and tolerability to radiotherapy is still controversial. A thoracoabdominal (TA) flap with a few technical refinements can safely transfer a larger flap while minimizing complications. METHODS: From January 2007 to February 2018, a retrospective review was performed to compare 2 groups after wide breast excision: skin graft group (group 1) and lateral-based, single vertical incision rotation-advancement TA flap (group 2). Patients' demographics, operative details, complications, hospital stay, postoperative outpatient visits, cost, and start of adjuvant therapy were analyzed between the 2 groups. RESULTS: During the study period, 34 patients received skin graft and 41 patients received TA flap. group 2 had a shorter hospital stay (6.41 ± 2.64 days vs. 12.62 ± 4.60 days, P 1 year was observed in 4 patients in only group 1 (43.90% vs. 38.24%, P = 0.613). CONCLUSION: TA flap has a simple design that minimizes concerns involving the donor site. Moreover, it does not require complicated procedures and allows for re-elevation whenever necessary. Finally, it guarantees faster wound recovery than skin graft with fewer complications.

Erysipelatoid Carcinoma

SUMMARY Erysipelatoid Carcinoma (EC), also known as Inflammatory Metastatic Carcinoma, is a rare form of cutaneous metastasis, secondary to an internal malignancy, more often related to breast cancer. Clinically, the lesion has a well-marked, bound erythematous appearance, much like an infectious process, such as erysipelas and cellulitis, these being the most common differential diagnoses. It is characterized by an acute or subacute appearance with an erythematous plaque, sometimes hot and painful, being more often situated in the primary tumor vicinity, especially in the thorax wall in the region of a mastectomy due to breast cancer. Here we present the case of a 75-year-old patient with ductal infiltrated carcinoma for 3 years, who presented an acute erythematous and infiltrated plaque in the region of a previous mastectomy, with a final diagnosis of EC.

Dermoscopy of inflammatory breast cancer

Abstract: Inflammatory breast cancer is an aggressive and infiltrative malignancy that is often misdiagnosed as an infection because of its symptoms and signs of inflammation, delaying proper diagnosis and treatment. We report a case of inflammatory breast cancer showing correlation between dermoscopic and histopathological diagnoses. We highlight the utility of dermoscopy for skin biopsy site selection.

Identificação de marcadores moleculares no carcinoma inflamatório de mama / Identification of molecular markers in inflammatory breast cancer

O carcinoma inflamatório de mama (CIM) é um tipo raro e agressivo de doença com prognóstico extremamente desfavorável e biologia molecular pouco conhecida. Neste estudo foram avaliadas alterações no número de cópias genômicas (CNA) e perdas de heterozigose de cópia neutra (cnLOH) em 24 casos de CIM. A partir destes dados foram calculados os escores (nTAI, LST e HRD-LOH) preditores da deficiência na via de recombinação homóloga (HR). Em 21 destes casos foram também avaliadas mutações em 105 genes relacionados com o câncer, sendo 13 envolvidos na via de recombinação homóloga (HR) por sequenciamento de alto desempenho (tNGS). A maioria dos CIM analisados apresentou um grande número de CNAs, demonstrando alta instabilidade genômica. Os ganhos genômicos foram mais frequentes que as perdas. As alterações mais frequentes foram ganhos em 1q32 e 8q24 e perdas em 17p13.1. As cnLOHs foram observadas em um grande número de casos, principalmente nos cromossomos 3p e 6q. Nas regiões alteradas foram identificados importantes genes incluindo aqueles envolvidos na resposta imunológica (como CD46, CD55 e CR1), de matriz extracelular, associados a processos metastáticos, entre outros. A análise de enriquecimento de vias biológicas destacou as vias envolvendo os genes MYC, SQLE e MDM4. Foram encontrados amplicons mapeados em 1q32.1 1q32.2 1q32.3, 8p23.1 e 17q12-q21.1, os quais podem estar associados com o fenótipo tumoral. Em adição, as amplificações de CD46 e CD55 podem levar a supressão da resposta imunológica, o que aponta para o potencial desses candidatos como alvos terapêuticos. Foram também identificadas mutações nos genes da via de HR: BRCA2, BRCA1, ATM, PALB2, RAD51B, RAD51D e MUS81. Ao menos um dos três escores de deficiência da via de HR foi alto em 15 dos 21 CIM, sendo 14 casos portadores de mutação em genes dessa via. Estes achados sugerem que os pacientes com CIM podem se beneficiar do tratamento com inibidores de PARP. Altos escores foram associados com menor sobrevida em relação aos casos com baixos valores (p<0,019). As mutações somáticas mais recorrentes ocorreram em TP53 (11 casos) e em BRCA2 (9 casos). Mutações no gene TP53 são frequentemente descritas em carcinomas mamários, incluindo CIM. As mutações em BRCA2 são menos frequentes em literatura do que as descritas em nosso estudo, possivelmente pelo significativo número de pacientes com história de câncer de mama. Este estudo permitiu a identificação de altos escores da via HR e mutações em genes da via de HR, os quais podem ser relevantes para o delineamento de estratégias terapêuticas mais eficazes para estas pacientes. Além disso, foram identificados novos candidatos associados com a resposta imunológica e a características de pior prognóstico, os quais precisam ser avaliados por diferentes estratégias moleculares e num grupo maior de casos de modo a contribuir para o avanço do conhecimento sobre esses raros e agressivos tumores (AU)

Inflammatory breast carcinoma (IBC) is a rare and aggressive disease with poor prognosis and its molecular biology is still poorly explored. In this report we evaluated copy number variations (CNAs) and copy neutral loss of heterozigosity (cnLOH) in 24 IBC samples. From these data, we calculated scores (nTAI, LST e HRD-LOH) predictors of Homologous Recombination Deficiency (HRD). A targeted-next generation sequencing was performed using a panel with 105 cancer-related genes (13 HR genes) in 21 samples. Most of the tumors presented a large number of CNAs showing high level of genomic instability. Genomic gains were more frequent than losses. Gains of 1q32 and 8q24 and losses of 17p13.1 were commonly detected. cnLOH was observed in almost all cases, mainly in chromosomes 3p and 6q. We have identified important genes mapped in these altered regions, including those involved in the immunological response (such as CD46, CD55 and CR1), extracellular matrix, metastatic process and others. An enrichment analysis using revealed pathways encompassing MYC, SQLE and MDM4 genes. We also detected amplicons mapped on 1q32.1 1q32.2 1q32.3, 8p23.1 and 17q12-q21.1, which may be associated with the tumor phenotype. Furthermore, amplification of CD46 and CD55 could promote immunological response suppression, which pointed out their potential as therapeutic targets. Mutations in HR genes were detected: BRCA2, BRCA1, ATM, PALB2, RAD51B, RAD51D and MUS81. At least one of three HR deficiency scores was high in 15 of 21 IBC being 14 HR mutated carriers. These findings suggest that IBC patients could benefit from PARP inhibitors treatment. Cases with high scores were associated with worse survival (p<0,019) compared with those with low scores. The mutational profile showed recurrent somatic mutations in TP53 (11 cases) and BRCA2 (9 cases). TP53 mutations are frequently reported in breast cancer, including IBC. BRCA2 mutations presented higher frequency in our CIM cases compared with the literature data, possibly by the significative number of patients with family history of breast cancer. This study allowed us to identify high scores values of HR pathway and HR gene mutations that could be translated into novel therapeutic strategies for the patients care. In addition, new candidates associated with immunological response and worse prognosis features were found. However, these findings need to be evaluated using different molecular strategies and a larger number of cases, which together has potential to contribute to better understand this rare and aggressive tumor (AU)

Reduction mammoplasty as a treatment for symptomatic central venous stenosis

Central venous stenosis is a rare cause of unilateral breast edema occurring in hemodialysis patients that needs to be differentiated from other differential diagnoses, including, but not limited to, inflammatory breast carcinoma, mastitis, lymphedema, and congestive heart failure. All reports of similar cases in the available literature have described improvement or resolution of the edema after treatment. Herein, we report and discuss the pathophysiology of breast edema formation in a patient who presented with massive left-sided breast edema 7 years after being diagnosed with central venous stenosis. Medical and minimally invasive therapy had not been successful, so she underwent reduction mammoplasty to relieve the symptoms.

Predicting Successful Conservative Surgery after Neoadjuvant Chemotherapy in Hormone Receptor-Positive, HER2-Negative Breast Cancer

PURPOSE: This study aimed to determine whether clinicopathological factors are potentially associated with successful breast-conserving surgery (BCS) after neoadjuvant chemotherapy (NAC) and develop a nomogram for predicting successful BCS candidates, focusing on those who are diagnosed with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative tumors during the pre-NAC period. METHODS: The training cohort included 239 patients with an HR-positive, HER2-negative tumor (≥3 cm), and all of these patients had received NAC. Patients were excluded if they met any of the following criteria: diffuse, suspicious, malignant microcalcification (extent >4 cm); multicentric or multifocal breast cancer; inflammatory breast cancer; distant metastases at the time of diagnosis; excisional biopsy prior to NAC; and bilateral breast cancer. Multivariate logistic regression analysis was conducted to evaluate the possible predictors of BCS eligibility after NAC, and the regression model was used to develop the predicting nomogram. This nomogram was built using the training cohort (n=239) and was later validated with an independent validation cohort (n=123). RESULTS: Small tumor size (p < 0.001) at initial diagnosis, long distance from the nipple (p=0.002), high body mass index (p=0.001), and weak positivity for progesterone receptor (p=0.037) were found to be four independent predictors of an increased probability of BCS after NAC; further, these variables were used as covariates in developing the nomogram. For the training and validation cohorts, the areas under the receiver operating characteristic curve were 0.833 and 0.786, respectively; these values demonstrate the potential predictive power of this nomogram. CONCLUSION: This study established a new nomogram to predict successful BCS in patients with HR-positive, HER2-negative breast cancer. Given that chemotherapy is an option with unreliable outcomes for this subtype, this nomogram may be used to select patients for NAC followed by successful BCS.

Oncologic Outcomes after Immediate Breast Reconstruction Following Total Mastectomy in Patients with Breast Cancer: A Matched Case-Control Study / 한국유방암학회지

PURPOSE: The use of immediate breast reconstruction (IBR) following total mastectomy (TM) has increased markedly in patients with breast cancer. As the indications for IBR have been broadened and more breast-conserving surgery-eligible patients are undergoing IBR, comparing the oncologic safety between TM only and IBR following TM becomes more difficult. This study aimed to analyze the oncologic outcomes between TM only and IBR following TM via a matched case-control methodology. METHODS: A retrospective review was conducted to identify all patients who underwent TM between 2008 and 2014. We excluded patients who underwent neoadjuvant chemotherapy, including palliative chemotherapy, and had a follow-up duration 0.050). Matching was considered successful for the matching variables and other factors, such as family history, histology, multiplicity, and lymphovascular invasion. There were no significant differences in overall survival (log-rank p=0.454), disease-free survival (log-rank p=0.186), local recurrence-free survival (log-rank p=0.114), or distant metastasis-free survival rates (logrank p=0.537) between the two groups. CONCLUSION: Our results suggest that IBR following TM is a feasible treatment option for patients with breast cancer.

Therapeutic effect of ethyl acetate extract from Asparagus cochinchinensis on phthalic anhydride-induced skin inflammation / 한국실험동물학회지

Asparagus cochinchinensis has been used to treat various diseases including fever, cough, kidney disease, breast cancer, inflammatory disease and brain disease, while IL-4 cytokine has been considered as key regulator on the skin homeostasis and the predisposition toward allergic skin inflammation. However, few studies have investigated its effects and IL-4 correlation on skin inflammation to date. To quantitatively evaluate the suppressive effects of ethyl acetate extracts of A. cochinchinensis (EaEAC) on phthalic anhydride (PA)-induced skin inflammation and investigate the role of IL-4 during their action mechanism, alterations in general phenotype biomarkers and luciferase-derived signals were measured in IL-4/Luc/CNS-1 transgenic (Tg) mice with PA-induced skin inflammation after treatment with EaEAC for 2 weeks. Key phenotype markers including lymph node weight, immunoglobulin E (IgE) concentration, epidermis thickness and number of infiltrated mast cells were significantly decreased in the PA+EaEAC treated group compared with the PA+Vehicle treated group. In addition, expression of IL-1β and TNF-α was also decreased in the PA+EaEAC cotreated group, compared to PA+Vehicle treated group. Furthermore, a significant decrease in the luciferase signal derived from IL-4 promoter was detected in the abdominal region, submandibular lymph node and mesenteric lymph node of the PA+EaEAC treated group, compared to PA+Vehicle treated group. Taken together, these results suggest that EaEAC treatment could successfully improve PA-induced skin inflammation of IL-4/Luc/CNS-1 Tg mice, and that IL-4 cytokine plays a key role in the therapeutic process of EaEAC.

A Randomized Phase II Trial of Capecitabine Plus Vinorelbine Followed by Docetaxel Versus Adriamycin Plus Cyclophosphamide Followed by Docetaxel as Neoadjuvant Chemotherapy for Breast Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Given the promising activity of capecitabine and vinorelbine in metastatic breast cancer, this randomized phase II trial evaluated the efficacy and safety of this combination as neoadjuvant chemotherapy in breast cancer. MATERIALS AND METHODS: Patients with operable breast cancer (n=75) were randomly assigned to receive either four cycles of adriamycin 60 mg/m2 plus cyclophosphamide 600 mg/m2 every 3 weeks followed by four cycles of docetaxel 75 mg/m2 every 3 weeks (AC-D) or four cycles of capecitabine 2,000 mg/m2 (day 1-14) plus vinorelbine 25 mg/m2 (days 1 and 8) every 3 weeks followed by four cycles of docetaxel 75 mg/m2 (CV-D). The primary endpoint was pathologic complete response (pCR) in the primary breast (ypT0/is). RESULTS: Most patients (84%) had locally advanced (n=41) or inflammatory breast cancer (n=22). pCR rates in the primary breast were 15% (95% confidence interval [CI], 7% to 30%) and 11% (95% CI, 4% to 26%) in the AC-D and CV-D groups, respectively. The overall response rates and 5-year progression-free survival rates in the AC-D and CV-D groups were 62% and 64%, and 51.3% (95% CI, 34.6% to 68.0%) and 30.2% (95% CI, 13.3% to 47.1%), respectively. Although both regimens were well tolerated, CV-D showed less frequent grade 3-4 neutropenia and vomiting than AC-D, whereas manageable diarrhea and hand-foot syndrome were more common in the CV-D group. CONCLUSION: CV-D is a feasible and active non-anthracycline-based neoadjuvant chemotherapy regimen for breast cancer.

Cutaneous Metastasis of Gastric Cancer Mimicking Primary Inflammatory Breast Cancer

No abstract available.

Primary Neuroendocrine Carcinoma of the Breast with Clinical Features of Inflammatory Breast Carcinoma: A Case Report and Literature Review / 한국유방암학회지

Primary neuroendocrine carcinoma of the breast (NECB) is a very rare type of invasive breast carcinoma. Most NECBs appear on breast imaging as solid masses of varied shapes and margins, and have worse clinical outcomes than does invasive ductal carcinoma, not otherwise specified. However, there have been no reports to date regarding NECB with features of inflammatory breast carcinoma. Here, we describe the clinical, radiol-ogic, and pathologic findings of the first reported case of primary NECB presenting as inflammatory breast carcinoma. The patient complained of diffuse right breast enlargement and erythema. Mammography identified severe breast edema and axillary lymphadenopathy. Ultrasound detected an irregular, angular, hypoechoic mass with dermal lymphatic dilatation. On magnetic resonance imaging, the mass had rim enhancement and the entire right breast showed heterogeneous enhancement with malignant kinetic features. Pathology identified the mass as a primary NECB with positive for synaptophysin, CD56, estrogen and progesterone receptors.

Inflammatory breast neoplasms: a systematic review

OVERVIEW: Inflammatory Breast Cancer (IBC) is a rare and very aggressive type of cancer that tends to develop at a younger age, compared with other subtypes of breast cancer. Because a distinct lump may not be noticeable, correct diagnosis takes longer and, therefore, successful treatment may hinder a patient's prognostics. This study aims to conduct a systematic review of research articles on IBC. METHODS: This is a systematic review of studies in the PubMed database to April 2013, which fit the eligibility criterion of "Inflammatory Breast Neoplasms" (MeSH Terms), filtered by Languages (English OR Portuguese OR Spanish). FINDINGS: Of the 119studies identified, 25 complied with the eligibility criterion for the disease, diagnostics, treatment and prognostics. FINAL CONSIDERATIONS: Despite methodological differences, findings evidence that although IBC presents particular features (lower survival rate and worse prognostics than most types of breast cancer), very few studies examine its epidemiology and specific risk factors in depth and use any other therapeutic approaches than those commonly used for other breast cancer subtypes. Therefore, further investigation of the disease's aggressiveness is still necessary.

Distinct outcomes in patients with different molecular subtypes of inflammatory breast cancer

To determine the outcome of patients with luminal A, luminal B, human epidermal growth factor receptor-2 [HER-2] positive, and triple negative molecular subtypes of inflammatory breast cancer [IBC] using a retrospective analysis. This study was conducted between February 2004 and February 2010 in 3 different hospitals in China. The clinical outcomes, pathological features, and treatment strategies were analyzed in 67 cases of IBC without distant metastases. A chi-square test and one-way ANOVA were used to assess outcomes between different subtypes. Overall survival [OS] was analyzed using the Kaplan-Meier method and multivariate analysis was conducted using the Cox regression model. The 2-year OS rate was 55% for the entire cohort. Median OS time among patients with luminal A was 35 months, luminal B was 30 months, HER-2 positive was 24 months, and triple negative subtypes was 20 months, and were significantly different from each other [p=0.001]. Using multivariate analysis, luminal A had 76% [p=0.037], luminal B had 54% [p=0.048], and HER-2 positive subtypes had 47% [p=0.032] decreased risk of death compared with the triple negative subtype. Furthermore, elevated Ki-67 labeling was associated with increased risk of death, while the surgical treatment significantly improved patient survival. Breast cancer subtypes are associated with distinct outcomes in IBC patients. Patients that presented with triple negative IBC had poorer outcome than luminal A, luminal B, and HER-2 subtypes. These results indicate that IBC is a heterogeneous disease similar to the conventional breast cancer

Carcinoma inflamatorio de mama en una mujer de 62 años: presentación de un caso / Breast Inflammatory Carcinoma in a 62 Years Old Woman: Case Report

Son múltiples los espectros de presentación del cáncer de mama; uno de ellos es el carcinoma inflamatorio. En el presente artículo se expone el caso de una paciente de 62 años en quien se diagnostica carcinoma inflamatorio por medio de los hallazgos clínicos, ecográficos y mamográficos, y se corroboran mediante patología. La relevancia del caso radica en que es un caso típico de carcinoma inflamatorio, incluyendo clínica, patología y características imaginológicas. Se hace una revisión epidemiológica, de presentación histológica, clínica y por imágenes, con el fin de orientar a radiólogos y clínicos en el diagnóstico de tan importante, pero infrecuente entidad.

There are multiple spectra of breast cancer presentations, one of which is inflammatory carcinoma. This article describes the case of a 62 year old patient with inflammatory carcinoma, diagnosed by clinical, ultrasound and mammography findings confirmed by pathology. This case is relevant because it is a typical case of inflammatory carcinoma, including clinical, pathology and imaging features. An epidemiological revision is made, with a histological, clinical and imaging presentation in order to guide radiologists and clinicians in the diagnosis of this important but uncommon entity.

Cáncer de mama inflamatorio / Breast cancer intrainflamatorio

El cáncer de mama inflamatorio es una patología poco frecuente, sin embargo, su importancia radica en la agresividad de su evolución. A nivel nacional no existe estadística certera respecto al porcentaje del cáncer inflamatorio de mama como tal. En el Hospital Base de Valdivia, constituye el 3,3 por ciento de los carcinomas mamarios invasores según una revisión de los últimos 3 años. El diagnóstico de esta patología está basado en la sospecha clínica, en pacientes que presenten eritema, edema, piel de naranja, nódulos y/o induración mamaria. La histopatología del tumor primario y de la piel permite la confirmación diagnóstica. En cuanto al tratamiento, en la actualidad existe consenso de que las pacientes deben ser sometidas a un tratamiento multimodal, éste consiste en quimioterapia neoadyuvante, para luego efectuar la terapia locorregional. Lo particular de este tipo de cáncer, es que posee características biológicas intrínsecas de rápida progresión y alto poder de diseminación, lo que le confiere un mal pronóstico.

Inflammatory breast cancer is a rare disease, but its importance lies in the aggressiveness of its evolution. At the national level there is no accurate statistics on the percentage of inflammatory breast cancer as such. In the Base Hospital of Valdivia, constitute 3.3 percent of invasive breast carcinomas according to a review of the past 3 years. The diagnosis of this disease is based on clinical suspicion in patients presenting with erythema, edema, cellulitis, nodules, and / or breast induration. The histopathology of the primary tumor and skin allows diagnostic confirmation. As for treatment, there is now consensus that patients should be subjected to a multimodal treatment, starting with neoadjuvant chemotherapy and then perform locoregional therapy. The particularity of this type of cancer is that it has intrinsic biological characteristics of rapid progression and high power spread, which gives a poor prognosis.

Metastatic Signet Ring Cell Carcinoma to the Breast: A Case Report

Metastasis of signet ring cell gastric carcinoma to the breast is extremely rare. The common clinical findings are redness, edematous skin and pain, and these findings are similar to those of inflammatory breast cancer. We describe here a case of metastatic signet ring cell gastric carcinoma to the bilateral breasts, and this presented as bilateral palpable breast lumps after the patient had undergone radical total gastrectomy two years previously.