Inflammatory breast cancer: PET/CT, MRI, mammography, and sonography findings

• Published in: Breast cancer research and treatment 2008-06, Vol.109 (3), p.417-426
• Main Authors: Yang, Wei T., Le-Petross, Huong T., Macapinlac, Homer, Carkaci, Selin, Gonzalez-Angulo, Ana M., Dawood, Shaheenah, Resetkova, Erika, Hortobagyi, Gabriel N., Cristofanilli, Massimo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - diagnostic imaging; Cancer research; Cancer therapies; Comparative studies; Female; Gynecology. Andrology. Obstetrics; Humans; Magnetic Resonance Imaging; Mammary gland diseases; Mammography; Medical diagnosis; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Neoplasms, Glandular and Epithelial - diagnosis; Neoplasms, Glandular and Epithelial - diagnostic imaging; Oncology; Positron-Emission Tomography; Review; Tomography; Tomography, X-Ray Computed; Tumors; Ultrasonic imaging; Ultrasonography
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-007-9671-z

Purpose To describe the role of Positron Emission Tomography/Computed Tomography (PET/CT), Magnetic Resonance Imaging (MRI), sonography, and mammography in patients with inflammatory breast cancer (IBC). Materials and methods Patients who had been newly diagnosed with IBC and who had undergone mammography, sonography, MRI, PET/CT, or a combination of these were included in this study. The visibility of breast parenchymal lesion (BPLs), skin abnormalities, regional (axillary, supraclavicular, or internal mammary) nodal disease, and distant metastatic disease was documented with the imaging techniques. Results Eighty patients (median age, 51 years, [range, 25–78 years]) were included in this study: 75 (94%) had undergone mammography, 76 (95%) sonography, 33 (41%) MRI, and 24 (30%) PET/CT. A primary BPL was found in 60 patients (80%) on mammography (mass or calcifications), 72 (95%) on sonography (mass or architectural distortion), 23 (96%) on PET/CT (hypermetabolic BPL), and 33 (100%) on MRI (enhancing BPL). Regional axillary nodal disease was found in 74 patients (93%) by histologic or cytologic examination, in 71 patients (93%) on sonography, in 21 (88%) on PET/CT, in 29 (88%) on MRI, and in 34 (45%) on mammography. Distant metastases in the bone, liver, and contralateral lymph nodes were diagnosed in nine patients (38%) on PET/CT. Conclusion MRI was the most accurate imaging technique in detecting a primary BPL in IBC patients. Sonography can be useful in diagnosing regional nodal disease. PET/CT provides additional information on distant metastasis, and it should be considered in the initial staging of IBC.