Surgical management of inflammatory breast cancer.

Multimodality therapy consisting of primary chemotherapy, mastectomy, and radiotherapy appears to offer the most favorable outcomes for patients with inflammatory breast carcinoma (IBC). Patients who respond well to chemotherapy are the best candidates for surgery; if response to chemotherapy is poor, radiotherapy should be undertaken before attempting surgery. The operative field must be wide enough to encompass all secondary skin changes, and every attempt should be made to assure negative margins. Breast-conserving surgery and sentinel lymph node biopsy are not appropriate for patients with IBC. However, there are no medical contraindications to breast reconstruction after mastectomy, although most clinicians prefer to wait until after the completion of radiotherapy before attempting this additional surgery.