Breast Cancer Awareness

Understanding Inflammatory Breast Cancer

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[October 31, 2017]  Inflammatory breast cancer (IBC) is rare. It differs from other types of breast cancer in its symptoms, outlook, and treatment. Symptoms include breast swelling, purple or red color of the skin, and pitting or thickening of the skin of the breast so that it may look and feel like an orange peel. Often, a lump is not felt. If you have any of these symptoms, it does not mean that you have IBC, but you should see a doctor right away.

What is inflammatory breast cancer?

Inflammatory breast cancer (IBC) has some symptoms of inflammation like swelling and redness. But infection or injury do not cause IBC or the symptoms. IBC symptoms are caused by cancer cells blocking lymph vessels in the skin.

How is inflammatory breast cancer different from other types of breast cancer?

Inflammatory breast cancer differs (IBC) from other types of breast cancer in several key ways:

  • IBC doesn't look like a typical breast cancer. It often does not cause a breast lump, and it might not show up on a mammogram. This makes it harder to diagnose.

  • IBC tends to occur in younger women (at an average age of 52 versus 57 for more common forms of breast cancer).

  • African-American women appear to be at higher risk of IBC than white women.

  • IBC is more common among women who are overweight or obese.

  • IBC also tends to be more aggressiveóit grows and spreads much more quicklyóthan more common types of breast cancer.

  • IBC is always at a locally advanced stage when itís first diagnosed because the breast cancer cells have grown into the skin. (This means it at least stage IIIB.)

  • In about 1 of every 3 cases, IBC has already spread (metastasized) to distant parts of the body when it is diagnosed. This makes it harder to treat successfully.

What are the signs and symptoms of inflammatory breast cancer?

Inflammatory breast cancer (IBC) causes a number of signs and symptoms, most of which develop quickly (withing 3-6 months), including:

  • Thickening (edema/swelling) of the skin of the breast

  • Redness involving more than one-third of the breast

  • Pitting or thickening of the skin of the breast so that it may look and feel like an orange peel

  • A retracted or inverted nipple
    One breast looking larger than the other because of swelling

  • One breast feeling warmer and heavier than the other

  • A breast that may also be tender, painful or itchy

Tenderness, redness, warmth, and itching are also common symptoms of a breast infection or inflammation, such as mastitis if youíre pregnant or breastfeeding. Because these problems are much more common than IBC, your doctor might at first suspect infection as a cause and treat you with antibiotics.

This may be a good first step, but if your symptoms donít get better in 7 to 10 days, more tests need to be done to look for cancer. The possibility of IBC should be considered more strongly if you have these symptoms and are not pregnant or breastfeeding, or have been through menopause.

IBC grows and spreads quickly, so the cancer may have already spread to nearby lymph nodes by the time symptoms are noticed. This spread can cause swollen lymph nodes under your arm or above your collar bone. If the diagnosis is delayed, the cancer can spread to lymph nodes in your chest or to distant sites.

If you have any of these symptoms, it does not mean that you have IBC, but you should see a doctor right away. If treatment with antibiotics is started, youíll need to let your doctor know if it doesn't help, especially if the symptoms get worse or the affected area gets larger. Ask to see a specialist (like a breast surgeon) or you might want to get a second opinion if youíre concerned.

How is inflammatory breast cancer diagnosed?

Imaging tests


If inflammatory breast cancer (IBC) is suspected, one or more of the following imaging tests may be done:

  • Mammogram
  • Breast ultrasound
  • MRI (magnetic resonance imaging) scan
  • CT (computed tomography) scan
  • PET (positron emission tomography) scan

Sometimes a photo of the breast is taken to help record the amount of redness and swelling before starting treatment.

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Biopsy

Breast cancer is diagnosed by a biopsy, taking out a small piece of the breast tissue and looking at it in the lab. Your physical exam and other tests may show findings that are "suspicious for" IBC, but only a biopsy can tell for sure that it is cancer.

Tests on biopsy samples

The cancer cells in the biopsy sample will be graded based on how abnormal they look. They will also be tested for certain proteins that help decide which treatments will be helpful.

The cells are tested for hormone receptors. Women whose breast cancer cells contain hormone receptors are likely to benefit from treatment with hormone therapy drugs.

Cancer cells are also tested to see if they contain too much of a protein called HER2/neu (often just called HER2) or too many copies of the gene for that protein. If they do, the woman may be helped by certain drugs that target HER2.

Stages of inflammatory breast cancer

All Inflammatory breast cancers start as Stage IIIB since they involve the skin. If the cancer has spread to lymph nodes around the collarbone or inside the chest, itís stage IIIC. Cancer that has spread outside the breast and nearby lymph nodes is stage IV.

Survival rates for inflammatory breast cancer

Inflammatory breast cancer (IBC) is considered an aggressive cancer because it grows quickly, is more likely to have spread at the time itís found, and is more likely to come back after treatment than other types of breast cancer. The outlook is generally not as good as it is for other types of breast cancer.

Survival rates are often based on previous outcomes of large numbers of people who had the disease, but they cannot predict what will happen in any particular person's case. Many other factors can affect a person's outlook, such as age, general health, treatment received, and how well the cancer responds to treatment. Your doctor can tell you how the numbers below may apply to you, as he or she is familiar with your situation.

These survival rates are based on people diagnosed years ago. Improvements in treatment since then may result in a more favorable outlook for people now being diagnosed with inflammatory breast cancer.

These numbers are based on data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database, for patients who were diagnosed with inflammatory breast cancer between 1990 and 2008.

Median survival is the length of time for half of the patients in a group to have died. By definition, half of the patients in that group are still alive. It is important to remember that the median is just a kind of average used by researchers. No one is "average" and many people have much better outcomes than the median. Also, people with inflammatory breast cancer can die of other things, and these numbers donít take that into account.

  • The median survival rate for people with stage III inflammatory breast cancer is about 57 months.
  • The median survival rate for people with stage IV inflammatory breast cancer is about 21 months.

How is inflammatory breast cancer treated?

Inflammatory breast cancer (IBC) that has not spread outside the breast or nearby lymph nodes is stage IIIB or IIIC. In most cases, treatment is chemotherapy to try to shrink the tumor, followed by surgery to remove the cancer. Radiation is given after surgery, and, in some cases, more treatment may be given after radiation.

IBC that has spread to other parts of the body (stage IV) may be treated with chemotherapy, hormone therapy, and/or with drugs that targets HER2.

For more information on the treatment of Inflammatory Breast Cancer, visit this link:

Treatment of Inflammatory Breast Cancer

[Text from American Cancer Society website[

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