Inflammatory Breast Cancer: A Multidisciplinary Approach

A discussion of the clinical presentation of patients with inflammatory breast cancer, the major differential diagnoses, and the critical role imaging plays.

Course ID: Q00391 Category:
Modalities: , , , , ,

2.5

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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Breast Sonography: 2.50
Patient Care: 1.00
Patient Interactions and Management: 1.00
Procedures: 1.50
Anatomy and Physiology: 0.25
Pathology: 0.50
Breast Interventions: 0.75

Mammography: 2.50
Patient Care: 1.00
Patient Interactions and Management: 1.00
Procedures: 1.50
Anatomy, Physiology, and Pathology: 0.75
Mammographic Positioning, Special Needs, and Imaging Procedures: 0.75

Magnetic Resonance Imaging: 1.50
Procedures: 1.50
Body: 1.50

Nuclear Medicine Technology: 1.50
Procedures: 1.50
Endocrine and Oncology Procedures: 1.50

Registered Radiologist Assistant: 2.50
Procedures: 2.50
Thoracic Section: 2.50

Sonography: 1.50
Procedures: 1.50
Superficial Structures and Other Sonographic Procedures: 1.50

Radiation Therapy: 2.50
Patient Care: 1.00
Patient and Medical Record Management: 1.00
Procedures: 1.50
Treatment Sites and Tumors: 0.75
Prescription and Dose Calculation: 0.25
Treatments: 0.50

Outline

  1. Introduction
  2. Clinical Presentation
  3. Differential Diagnosis
  4. Differentiating Primary IBC from LABC
  5. Skin Punch Biopsy
  6. Role of Imaging in Diagnosis of IBC
    1. Typical Mammographic Appearance
    2. US for Pretreatment Workup
    3. MR Imaging
    4. PET/CT with 18F Fluorodeoxyglucose for Initial Staging
  7. Imaging Studies to Assess Treatment Response
  8. FDG PET/CT to Monitor Treatment Response
  9. How Imaging Helps the Oncologist
  10. How Imaging Helps the Surgeon
  11. How Imaging Helps the Radiation Oncologist
  12. Role of Molecular Imaging
  13. Imaging for Recurrence, Restaging, and Metastases
    1. Follow-up Imaging
    2. Secondary IBC
  14. Prognosis and Significance
  15. Summary

Objectives

Upon completion of this course, students will:

  1. know the requirements for a confirmation of IBC diagnosis
  2. identify the three components of the tri-modality treatment regimen for IBC
  3. recognize uses for imaging in the IBC diagnosis and treatment processes
  4. recognize the common symptoms of IBC at clinical presentation
  5. know the common sites for IBC metastases at clinical presentation
  6. understand the term “differential diagnosis”
  7. identify the key feature that differentiates IBC from non-IBC LABC
  8. know the differentiators between IBC and LABC
  9. know the two more proliferative intrinsic molecular subtypes of breast cancer associated with IBC
  10. recognize the testing methods for HER2
  11. know when HER2 testing should occur
  12. be familiar with breast cancer hormone receptor status options and what this means for hormonal therapy effectiveness
  13. understand how the combined under-expression of one particular gene with over-expression of another could aid in IBC formation
  14. be familiar with the two genes which are over-expressed in IBC and contribute to the formation of emboli and increased metastases
  15. know the layers of tissue removed with a skin punch biopsy
  16. know how IBC typically appears on mammography
  17. identify the uses for ultrasound imaging for IBC patients
  18. be familiar with the BI-RADS® breast assessment categorization method
  19. understand the uses for MR imaging for IBC patients
  20. identify the most accurate imaging method for detecting IBC primary lesions
  21. understand the difficulties with evaluating IBC tumor size
  22. know the anatomical areas to be included in MR imaging of IBC patients
  23. identify the advantages of FDG PET/CT imaging in IBC diagnosis
  24. identify a possible reason for using caution with MR imaging for IBC follow up
  25. be familiar with the appearance of IBC response to neoadjuvant chemotherapy on MR images
  26. be familiar with the criteria for lesion and pathological lymph node measurement in RECIST evaluation via CT imaging
  27. understand the RECIST 1.1 response categories
  28. understand how FDG uptake is a predictor of good neoadjuvant chemotherapy response
  29. understand the reasoning for preoperative chemotherapy being the standard of care for IBC patients
  30. identify the uses for post-treatment imaging for IBC patients
  31. understand how imaging benefits the surgeon in IBC cases
  32. identify the radiation treatment fields that are often standard for IBC patients
  33. be familiar with some of the different radiotracers for molecular imaging
  34. identify potential uses of PET radiotracers for imaging IBC
  35. know the treatment goals for patients with metastatic IBC