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 aggressive—it grows and spreads much
more quickly—than more common types of breast cancer.
-
IBC is always at a locally advanced stage when it’s 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 you’re 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 don’t 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, you’ll 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 you’re 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, it’s 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
it’s 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 don’t 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[ |