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Targeting the cancer microenvironment: inflammatory breast cancer management
Published on May 31, 2020 38 min
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My name is Naoto Ueno. I am the Executive Director of Morgan Welch Inflammatory Breast Cancer Research Program and Clinic at MD Anderson Cancer Center. Today I am going to be talking about "Targeting Cancer Microenvironment", particularly for inflammatory breast cancer management.
This picture depicts typical appearance of inflammatory breast cancer. You can see that right breast is engorged and there is some slight redness. And you can see the edema. A 'peau d'orange' changes are also another typical change that we see. The question remains, what are the mechanistic underlying things contributing to the cause of this erythema?
One of the mechanism that people have been speculating is that, from the pathology perspective, there is a tumor emboli in the dermal lymphatic channel that causes skin inflammatory changes. The question remains that whether these inflammatory changes are simply immunological or true inflammation, and that remains unknown. This review paper actually talks about different aspects of potential causes of inflammatory breast cancer.
So inflammatory breast cancer is one of the most aggressive breast cancer. It represents about 2 to 4% of breast cancer in the United States. When you look from the perspective of the breast cancer deaths in the United States, it represents about 10%. Now in North and Western Africa, such as Egypt, Tunisia, Senegal, it is a major health issue, because inflammatory breast cancer represents about 15%. Also, the limited healthcare access results in a higher rate of breast cancer mortality. The appearance I have shown you before, commonly is misdiagnosed as mastitis, because it looks inflamed and it is probably appropriate to say that this appears like mastitis. So therefore treating with antibiotics is a first round of clinical practice. But once the antibiotic is not working, we need to consider that there is a possibility of inflammatory breast cancer. The other thing that we have to remember is that this type of breast cancer does not always have a mass. If you do a mammogram, roughly 30 to 40% of women will not have any mass, and that's where the confusion starts, because our general expectation about breast cancer is that you're supposed to see a mass.