- Posted by jdavis on July 25, 2011
Despite its name, inflammatory breast cancer does not cause inflammation the way an infection does. One or more of the following are typical symptoms of IBC:
- Rapid change in the appearance of one breast, over the course of days or weeks
- Thickness, heaviness or visible enlargement of one breast, sometimes a cup size in a few days
- Discoloration, giving the breast a red, purple, pink or bruised appearance
- Unusual warmth of the affected breast
- Dimpling or ridges on the skin of the affected breast, similar to an orange peel
- Tenderness, pain or aching
- Enlarged lymph nodes under the arm, above the collarbone or below the collarbone
- Flattening or turning inward of the nipple
- Swollen or crusted skin on the nipple
- Nipple discharge
- Breast pain (from a constant ache to stabbing pains)
- Change in color of the skin around the nipple (areola)
If you suddenly develop a lump or mass, have it checked immediately. In one reported case, a 9x8x5cm lump developed in only three weeks.
Use caution when relying on the interpretations and reports of the mammogram or ultrasound! Inflammatory breast cancer usually grows in nests or sheets, rather than as a confined solid tumor. IBC may not be detected using either mammography or ultrasonography. Increased breast density compared to prior mammograms should be considered suspicious.
Other conditions have symptoms resembling those of inflammatory breast cancer. A breast infection (mastitis) also causes redness, swelling and pain, but breast infections usually develop during breast-feeding. With an infection, you’re likely to have a fever, which is unusual (but not unheard of) in inflammatory breast cancer.
Remember: You don’t have to have a lump to have breast cancer.
A diagnosis of inflammatory breast cancer is based primarily on your medical history and your physical examination. Mammogram, ultrasound and biopsy can be used to confirm the diagnosis. An excisional biopsy that includes the skin is helpful because a hallmark of inflammatory breast cancer is finding tightly packed clumps of cancer cells (tumor emboli) in the lymphatic vessels of the skin.
If the biopsy results confirm that you have inflammatory breast cancer, the next step is to determine how advanced your cancer is — its stage, or extent and severity. Your doctor may perform additional tests, such as a CT scan of your chest and abdomen, chest X-ray, and bone scan, to check for the presence of cancer cells in other parts of your body (metastases).
Your cancer will also be tested for the presence or absence of receptors for the hormones estrogen and progesterone, and to see if the cancer produces too much of a protein called HER2. Inflammatory breast cancers are often hormone receptor negative and HER2-positive.
Inflammatory breast cancer is classified as stage IIIB or stage IV breast cancer. Stage IIIB is locally advanced cancer — meaning it has spread to nearby lymph nodes and to the fibrous connective tissue inside the breast. Stage IV cancer has spread to other parts of your body, such as bones or liver. About one-third of newly diagnosed inflammatory breast cancers are stage IV.
Treatment for inflammatory breast cancer starts with chemotherapy, followed by surgery and radiation therapy. This combined-treatment approach has improved the outlook for women with inflammatory breast cancer. About half the women diagnosed with the condition survive five or more years, and nearly one-third are alive 20 years after diagnosis.
Chemotherapy (anti-cancer drugs)
Treatment of inflammatory breast cancer usually begins with several rounds of chemotherapy to kill or control cancer cells. This pre-surgical treatment, referred to as neoadjuvant therapy, is needed to shrink the cancer and resolve skin problems before the operation, since swelling can prevent the surgical incision from healing properly. The exact number of chemotherapy treatments will depend on how well the cancer responds to the treatments.
After chemotherapy, women with inflammatory breast cancer usually have an operation to remove the affected breast (mastectomy). Surgery alone — without chemotherapy — offers a much smaller chance of a cure. Breast-conserving surgery (lumpectomy) isn’t recommended for women with inflammatory breast cancer. Most women receive additional doses of chemotherapy after healing from the operation.
After surgery and any further chemotherapy, a course of radiation therapy is given to kill any remaining cancer cells in the breast and under your arm. This can help decrease the chance of cancer coming back in the area. Radiation typically involves about 30 treatments over six weeks.
Even after treatment with chemotherapy, surgery and radiation, recurrence rates remain high for inflammatory breast cancer. Because of this, your doctor may recommend further treatment (adjuvant therapy) to prevent the cancer from returning. This might include more chemotherapy or hormone therapy if your cancer tests positive for estrogen receptors. Hormone therapy, such as tamoxifen or anastrozole (Arimidex), interferes with the effects of the female hormone estrogen, which can promote cancer cell growth.