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Inflammatory Breast Cancer Course

 
     Introductory video transcript:
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Course Overview

Inflammatory breast cancer is a rare but aggressive form of breast cancer. Although it accounts for 2-6% of all breast cancers, the 5-year overall survival rate is only 40% while the 5-year overall survival rate for all types of breast cancer combined is nearly 90%. Because of the difficulty in diagnosing this cancer, the key to survival is early and accurate diagnosis and referral to health care providers that specialize in inflammatory breast cancer. Inflammatory breast cancer can present in a number of ways, and each patient’s symptoms are unique. Faculty members at The University of Texas MD Anderson Cancer Center founded the first clinic in the world solely dedicated to studying and treating this disease. In this series of lectures, the founders of The Morgan Welch Inflammatory Breast Cancer Research Program and Clinic at The University of Texas MD Anderson Cancer Center present introductory lectures on clinical diagnosis, multidisciplinary treatment, and biological features of this fast-growing, elusive, and often deadly type of breast cancer.

Please check this site often as new lectures will be added to this series.


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Lectures

Inflammatory Breast Cancer: Clinical Diagnosis   Top of Page

Wendy Woodward, M.D., Ph.D.  
Presenter: Wendy Woodward, M.D., Ph.D.
Associate Professor, Radiation Oncology

 

Summary: One of the major difficulties in effectively diagnosing IBC is recognizing the signs and symptoms of this complex disease. Patients are frequently misdiagnosed, often because no clinical mass is apparent, or signs of a rash-like symptom appear and are inappropriately treated with antibiotics for a long period of time, ultimately delaying treatment. In this lecture, “Inflammatory Breast Cancer: Clinical Diagnosis,” Dr. Wendy Woodward, Associate Professor of Radiation Oncology at The University of Texas MD Anderson Cancer Center, says a comprehensive baseline assessment and timely initiation of appropriate therapy is essential for improved patient outcomes. Dr. Woodward reviews the epidemiology, etiology, biology, pathologic features, screening techniques, and presenting signs and symptoms of IBC.
     Summary and Learning Objectives:
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Diagnostic Imaging   Top of Page

Wei Tse Yang, M.D.  
Presenter: Wei Tse Yang, M.D.
Professor
Department of Diagnostic Radiology

Summary: Inflammatory breast cancer is an extremely rare and aggressive disease that accounts for 1-5% of all breast cancers. “Early monitoring of patients using imaging is critical in the detection of non-responders,” says Dr. Wei Tse Yang, Professor in the Department of Diagnostic Radiology, Chief of the Section of Breast Imaging, and Medical Director of the Ben and Julie Rogers Breast Diagnostic Clinic at The University of Texas MD Anderson Cancer Center. In her lecture, “Inflammatory Breast Cancer: Diagnostic Imaging,” Dr. Yang discusses the clinical presentation of inflammatory breast cancer and the useful features of conventional mammography, sonography, and magnetic resonance imaging (MRI) for diagnosis, staging, and treatment planning. She emphasizes the importance of optimal imaging using sonography and MRI in the initial staging of inflammatory breast cancer, as well as the importance of image-guided biopsy using these modalities for diagnosis and biomarker evaluation. She also explains the role of positron emission tomography-computed tomography in the detection of distant metastasis and enumerates the differences between IBC and locally advanced breast cancer on imaging. Dr. Yang also demonstrates how advanced imaging tools may be used to monitor therapeutic response and, thus, patient outcomes.
     Summary and Learning Objectives:
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Inflammatory Breast Cancer Pathology   Top of Page

Savitri Krishnamurthy, M.D.  
Presenter: Savitri Krishnamurthy, M.D.
Professor, Department of Pathology

 

Summary: Inflammatory breast cancer (IBC) is a rare, aggressive type of breast cancer that compromises 1-5% of all newly diagnosed breast cancers. Physician recognition and early diagnosis of IBC are critical because the overall survival rate is lower for it than for other breast cancers (50%). Dr. Savitri Krishnamurthy, Professor of Pathology at The University of Texas MD Anderson Cancer Center, said that "Recognition of inflammatory breast carcinoma by physicians and awareness of the public is definitely essential for accurate diagnosis and optimal clinical management of the patients." In her lecture, entitled Inflammatory Breast Cancer Pathology, Dr. Krishnamurthy identifies the diagnostic criteria for establishing a diagnosis of IBC and describes how to recognize the pathological features of IBC in the skin and breast, the differential diagnosis of IBC, and how to be become familiar with the distribution of standard and potentially useful biomarkers in IBC tissue sections.
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Inflammatory Breast Cancer: Need for a Multidisciplinary Approach to Provide the Best Cancer Treatment   Top of Page

Naoto T. Ueno, M.D., Ph.D.  
Presenter: Naoto T. Ueno, M.D., Ph.D.
Professor, Breast Medical Oncology

 

Summary: Inflammatory breast cancer (IBC) is a Stage III disease at the time of presentation. Additionally, one-third of newly diagnosed patients may have metastasis. It is, therefore, essential for patients to undergo multidisciplinary management of this aggressive disease as early as possible. Dr. Naoto Ueno, Executive Director of The Morgan Welch IBC Research Program and Clinic, and Section Chief of the Translational Breast Cancer Research Department of Breast Medical Oncology at The University of Texas MD Anderson Cancer Center, urges referral to an IBC specialist before any treatment begins. Dr. Ueno describes the basic diagnosis of IBC, defines the standard of care for treatment of IBC, and reiterates why it is essential for patients to participate in clinical trials.
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Inflammatory Breast Cancer: Biological Features   Top of Page

Massimo Cristofanilli, M.D.  
Presenter: Massimo Cristofanilli, M.D.
Professor of Medicine

 

Summary: Dr. Massimo Cristofanilli, Adjunct Professor of Breast Medical Oncology and Founder of the Morgan Welch Inflammatory Breast Cancer Center at The University of Texas MD Anderson Cancer Center, says “Novel targets are being identified and it is possible that this will be translated very soon in promising clinical trials that can improve the overall prognosis and the outcome of patients.” Understanding the biological features that underlie the malignant course of inflammatory breast cancer [IBC] and the molecular characteristics that distinguish IBC from non-inflammatory breast cancers are necessary for the development of new targeted therapies that will improve patient outcomes. In this lecture, Dr. Cristofanilli describes the clinical and pathological features of IBC and the role of targeted therapies in the standard management of the disease. He also reviews several key studies revealing new molecular targets with potential therapeutic application.
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The Role of Surgery in Inflammatory Breast Cancer Patients   Top of Page

Anthony Lucci Jr., M.D.  
Presenter: Anthony Lucci Jr., M.D.
Professor, Department of Surgical Oncology

 

Summary: Surgery is an important component in treatment planning for patients with Inflammatory Breast Cancer (IBC). Dr. Anthony Lucci, Professor of Surgical Oncology at The University of Texas MD Anderson Cancer Center said that “Surgery can help achieve local control in the majority of patients,” but he recommends surgery not as the first step of treatment but as part of a trimodal protocol. “Systemic therapy up front is key to a better outcome for patients,” said Dr. Lucci. In his lecture, The Role of Surgery in Inflammatory Breast Cancer Patients, Dr. Lucci presents recent data on patient outcomes following mastectomy vs multiple modality therapy, and explores several case scenarios that show why neoadjuvant chemotherapy followed by mastectomy and then radiation therapy has proven to produce the best results in most IBC patients. Additionally, Dr. Lucci discusses optimal surgical treatments for the breast and regional lymph nodes in patients with IBC and identifies reconstructive and rehabilitative issues after surgery.
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Locoregional Treatment and Survival in Inflammatory Breast Cancer   Top of Page

Thomas A. Buchholz, M.D.  
Presenter: Thomas A. Buchholz, M.D.
Director, Inflammatory Breast Cancer Program
Professor and Chair, Department of Radiation Oncology
Professor, Department of Pathology

Summary: Multimodality treatment is best for patients with inflammatory breast cancer. Patients who receive systemic therapy followed by mastectomy can derive great benefit from postmastectomy radiation to reduce the likelihood of locoregional recurrence. Dr. Thomas Buchholz, Director of The Inflammatory Breast Cancer Program and Professor and Chair of the Department of Radiation Oncology at The University of MD Anderson Cancer Center, says data show that “[post-mastectomy radiation] is going to result in an overall survival advantage for patients with inflammatory breast cancer.” In his lecture, “Locoregional Treatment and Survival in Inflammatory Breast Cancer,” Dr. Buchholz reviews the historical evidence that underpins multimodality treatment protocols for locoregional control of inflammatory breast cancer. He identifies the factors associated with treatment outcomes and the survival benefits that occur in patients treated with radiation therapy. He then discusses the importance of specialized radiation techniques and doses in the multimodality approach used to treat patients with inflammatory breast cancer. Dr. Buchholz also presents recent data that analyze which molecular subtypes are associated with locoregional recurrence and how each subtype affects survival in 316 MD Anderson patients with inflammatory breast cancer. Dr. Buchholz discusses the critical need to develop novel therapeutic approaches for patients with inflammatory breast cancer, particularly those with triple-negative disease.
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