以瀰漫性紅腫為表徵之發炎性乳癌

Inflammatory Breast Cancer with Diffuse Breast Erythema and Swelling as Symptoms

臨床上，乳房紅腫常會讓人聯想為乳房發炎性疾病。本案例是一位44歲女性，因右側乳房瀰漫性紅腫約四週未改善就醫，後診斷為右側乳癌第三期，並行右側乳房根除性手術，術後三週，住院計畫做化療，發現白血球升高、右胸壁及右腋下多處復發。考量疾病進展迅速，回溯過去病史、治療過程及病理報告，最後診斷為發炎性乳癌（Inflammatory Breast Cancer, IBC），予以多模式治療後，腫瘤消除。發炎性乳癌相當罕見，沒有特定組織學，易與乳房發炎性疾病及其它局部嚴重晚期乳癌（Locally Advanced Breast Cancer, LABC）混淆。建議臨床同仁，如果乳房有發炎現象，使用抗生素兩週無效時，須將發炎性乳癌列為鑑別診斷並將其特徵謹記於心，以免延誤治療和危害病人生命。

 

In clinical practice, breast erythema is often linked to breast inflammatory diseases. The case of this study is a 44-year-old female, who went to the hospital due to diffuse erythema with swelling on the right breast for four weeks. She was initially diagnosed with stage III breast cancer and received a right-side radical mastectomy. When she was admitted for chemotherapy three weeks after the sur-gery, she was found to have leukocytosis and multiple metastasis over the right chest wall and right axillary. Therefore, cancer recurrence was suspected. Considering the rapid progression of the disease and reviewing past medical history, medical treatment procedures, and pathological report, the final diagnosis of inflammatory breast cancer (IBC) was made. After multimodal treatments, the tumors were eliminated. Given that IBC is easily confused with inflammatory diseases and other locally advanced breast cancer (LABC), if the breast is inflamed and antibiotic treatments are not effective for two weeks inflammatory breast cancer (IBC) must be included in the differential diagnosis. The healthcare provider must keep IBC’s characteristics in mind to avoid delay treatment which might en-danger the patient’s life.