Current status and advances in the diagnosis and treatment of inflammatory breast cancer

Abstract:

Inflammatory breast cancer (IBC) is a rare but highly aggressive subtype of breast cancer characterized by rapid clinical progression and poor prognosis. Although it accounts for only 2%-4% of all breast cancer cases, it is responsible for 8%-10% of breast cancer-related mortality. The etiology of IBC is multifactorial, involving genetic, hormonal, environmental, and socioeconomic factors. Pathologically, IBC is marked by the presence of dermal lymphatic tumor emboli, and molecular subtypes are predominantly HER2-positive and triple-negative, indicating high tumor invasiveness. Diagnosis relies on characteristic clinical manifestations and histopathological confirmation, while imaging techniques such as MRI and PET/CT play important roles in evaluating disease extent and metastasis. Given that IBC is often diagnosed at a locally advanced or metastatic stage, there is currently no specific treatment protocol. Instead, management generally follows the treatment paradigm of non-IBC, emphasizing systemic therapy within a multidisciplinary framework. HER2-positive IBC benefits from chemotherapy combined with dual-targeted anti-HER2 therapy; triple-negative IBC may respond to immune checkpoint inhibitors; and CDK4/6 inhibitors show potential efficacy in hormone receptor-positive subtypes. Despite advancements, the prognosis remains poor, with a high risk of early recurrence and distant metastasis. Prognostic factors include lymph node involvement, molecular subtype, and response to neoadjuvant therapy. As research into the tumor microenvironment and molecular mechanisms deepens, targeted and individualized therapies hold promise for improving outcomes. This review summarizes the epidemiology, pathology, diagnostic criteria, treatment strategies, and prognostic factors of IBC, aiming to inform clinical practice and future research.