Table 2. UK recommendations for the management of IBC.

MDT	Surgery	Chemotherapy	Endocrine therapy	Radiotherapy
✓ Case discussion with all clinical, imaging and pathology, including biomarker status, available	✓ Mastectomy ✓ In selected cases responding well to primary systemic therapy, a breast conservation approach may be considered ✓ Immediate reconstruction is not recommended. Delayed breast reconstruction is an appropriate option following mastectomy ✓ Axillary clearance recommended for patients with histologically (or cytologically) proven lymph node involvement identified by fine-needle aspiration core biopsy or sentinel lymph node biopsy	✓ Assess fitness to receive primary systemic chemotherapy (a full-dose anthracycline- and taxane-containing chemotherapy regimen such as sequential docetaxel-FEC) Anti-HER2 therapy in HER-2-positive IBC should be administered concurrently with chemotherapy with co-administration of anthracycline and anti-HER2 therapy considered in patients with no cardiac risk factors ✓ Assessment of response to primary systemic chemotherapy should include a combination of physical examination and radiological assessment. MRI is recommended for baseline evaluation and response assessment	✓ All hormone receptor-positive cancers	✓ Post mastectomy, chest wall radiotherapy is currently recommended irrespective of response to systemic therapy ✓ Supraclavicular fossa radiotherapy should be given where there is clinical pathological or radiological documentation, or suspected axillary node involvement according standard treatment protocols

Abbreviations: IBC=inflammatory breast cancer; MDT=Multi-Disciplinary Team; MRI=magnetic resonance imaging.