Inflammatory breast cancer (IBC) is characterized by rapid onset of skin erythema and peau d'orange. Which of the following is the most characteristic histopathological finding that distinguishes IBC?
- A High nuclear grade with extensive necrosis
- B Bilateral lymphocytic infiltrate
- C Tumor emboli within dermal lymphatics ✓
- D Signet ring cell morphology
Correct answer: C. Tumor emboli within dermal lymphatics
Explanation
Inflammatory breast cancer is characterized histologically by tumor emboli within the dermal lymphatics, which causes lymphatic obstruction leading to the clinical features of skin erythema, warmth, peau d'orange (skin pitting resembling orange peel), and rapid onset. IBC is a clinical-pathological diagnosis and may not always have a palpable mass; biopsy of affected skin confirms dermal lymphatic invasion. It carries a poor prognosis and is managed with neoadjuvant chemotherapy before surgery.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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