ABSTRACT
Mammography may show an abnormality; if so, it should be biopsied. If mammography does not provide useful information, then ultrasonography with biopsy of any suspicious areas should be performed. If ultrasonography does not show any areas to biopsy, obtaining a core, blind biopsy of the breast and some skin is the next step. This often shows adenocarcinoma with dermal lymphatic invasion, which is the hallmark of inflammatory breast cancer. CT of the chest and abdomen is an appropriate part of the work-up but will not help to establish the diagnosis. Positron emission tomography will not differentiate between mastitis and cancer, and tissue biopsy is necessary for the diagnosis. MRI is being studied in this setting; it is not routinely recommended at this time, but it may prove to be helpful in select cases.
