What is inflammatory breast cancer, and how is it different from other types of breast cancer?

Inflammatory breast cancer (IBC) is a rare and particularly aggressive form of breast cancer, in which cancer cells clog the lymph vessels. According to the National Cancer Institute, IBC accounts for only 1-5% of breast cancer cases in the U.S. Unlike more common types of breast cancer, due to the nature of IBC, it is always diagnosed as advanced-stage cancer (meaning that it at least involves nearby tissues and/or lymph nodes and may involve other areas of the body as well). Because IBC is difficult to detect before symptoms appear and advances quickly, it’s important to see your doctor as soon as you notice breast changes that may indicate IBC. 

What are the symptoms of inflammatory breast cancer?

Unlike other types of breast cancer that begin with a distinct lump or mass, the first sign of IBC is usually a thickening, swelling, or reddening of the skin. IBC symptoms are very similar to those of mastitis, a breast infection that causes inflammation of the milk ducts and primarily (but not exclusively) affects nursing mothers. If you’ve been diagnosed with mastitis or other infection of the breast, and it’s not responding to treatment, ask your doctor about being tested for IBC. Typical IBC symptoms include

• Swelling of breast or nearby lymph nodes (under the arm or above the collarbone)
• Reddening of the skin on the breast (redness may come and go)
• Change in nipple shape, such as flattening or inversion
• Breast engorgement
• A feeling of warmth, aching, or burning in the breast
• An “orange-peel” appearance to the skin (referred to as “peau d’orange” – literally, “skin of an orange.”
• Other skin changes, such as bruising, welts, hives, or ridges.

It’s important to keep in mind that these symptoms can also be caused by conditions other than cancer. Prompt consultation with your doctor will help to pinpoint and address the cause before your condition worsens.

How is IBC diagnosed?

IBC is most often diagnosed after the patient or her doctor sees or feels changes in the breast as described above. At this point, the doctor will likely order a mammogram, which may show thickened skin and/or a difference in size or density between the two breasts. Often, a breast ultrasound is ordered as well. An ultrasound test can detect enlargement of nearby lymph nodes as well as guide a biopsy, which is necessary for a definitive diagnosis.

How is IBC treated?

Current IBC treatments involve a multifaceted strategy to diminish and remove the cancer and prevent it from returning. Treatment usually includes chemotherapy, surgery, and radiation and, depending on the specific type of IBC found, may also include targeted or hormone therapies.

• Administering chemotherapy prior to surgery helps to shrink the cancer and reduce swelling, increasing the effectiveness of surgical treatment. If the cancer tests positive for hormone or HER2 receptors, then hormone or targeted medications can also be helpful in this capacity.
• Drug treatments are typically followed by modified radical mastectomy, in which the entire breast and at least some of the nearby lymph nodes are removed. Breast-conserving surgery is not often recommended for IBC because of its aggressiveness.
• Surgery is normally followed up with radiation to destroy any cancer cells that may remain. Additional drug treatments may also be recommended, both to treat any remaining cancer and to prevent its return after it’s been eliminated.

Iowa Radiology strives to give our patients the information they need to make the best possible decisions about their health and make them as comfortable as possible during radiologic exams and treatments. Click here to contact us about scheduling your annual screening mammogram. Have questions about mammography? Take a look at our free eBook, “What You Need to Know About Your Mammogram,” by clicking the link below.

Sources

"How is inflammatory breast cancer diagnosed?" Cancer.org. American Cancer Society, n.d. Web. 29 Dec 2015.

"Inflammatory Breast Cancer." Breastcancer.org. Breastcancer.org, n.d. Web. 29 Dec 2015.

"Inflammatory Breast Cancer." Cancer.gov. National Cancer Institute, n.d. Web. 29 Dec 2015.

"Inflammatory Breast Cancer." MayoClinic.org. Mayo Foundation for Medical Education and Research, n.d. Web. 20 Dec 2015.

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