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Chest Wall Disease: The Clinical Continuum Between Inflammatory and Lymphangitic Breast Cancer

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Breast Cancer

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Abstract

Chest wall disease represents a presentation of a clinical spectrum ranging from inflammatory to lymphangitic breast cancer. Inflammation and the immune response have long been viewed as a delicate balance that has the ability to promote a durable tumor regression or promote tumor progression. Preclinical models and biomarker studies suggest that inflammatory breast cancer comprises a more important role for the tumor microenvironment, including immune cell infiltration and vasculogenesis, especially lympho-angiogenesis. Across this clinical continuum of the chest wall disease, there is an important role of the inflammation cascade. The activation of mature dendritic cells (DCs) through toll-like receptors (TLRs) or by inflammatory cytokines converts immature DCs into mature DCs that present specific antigen to T cells, thereby activating them. Maturation of DCs is accompanied by co-stimulatory molecules and secretion of inflammatory cytokines polarizing lymphocytic, macrophages, and fibroblast infiltration. It is unknown whether immune cells associated to the IBC microenvironment play a role in this scenario to transiently promote epithelial to mesenchymal transition (EMT) in these cells. Immune and microenvironment factors can induce phenotypic, morphological, and functional changes in breast cancer cells. We can hypothesize that similar inflammatory conditions in vivo may support both the rapid metastasis and tight tumor emboli that are characteristic of chest wall disease and that targeted anti-inflammatory therapy may play a role in this patient population.

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Authors and Affiliations

  1. Breast Cancer Program, Division of Early Drug Development for Innovative Therapies, Istituto Europeo di Oncologia, Via Ripamonti 435, 20133, Milano, Italy

    Giuseppe Curigliano M.D., Ph.D.

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  1. Giuseppe Curigliano M.D., Ph.D.
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Correspondence to Giuseppe Curigliano M.D., Ph.D. .

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Editors and Affiliations

  1. European Institutee of Oncology, Milan, Italy

    Umberto Veronesi

  2. European Institute of Oncology, Milan, Italy

    Aron Goldhirsch

  3. European Institute of Oncology, Milan, Italy

    Paolo Veronesi

  4. San Raffaele University and Research Hospital, Milano, Italy

    Oreste Davide Gentilini

  5. European Institute of Oncology, Milan, Italy

    Maria Cristina Leonardi

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Curigliano, G. (2017). Chest Wall Disease: The Clinical Continuum Between Inflammatory and Lymphangitic Breast Cancer. In: Veronesi, U., Goldhirsch, A., Veronesi, P., Gentilini, O., Leonardi, M. (eds) Breast Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-48848-6_60

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  • DOI: https://doi.org/10.1007/978-3-319-48848-6_60

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