Inflammatory Breast Cancer

What is inflammatory breast cancer?

A rare and aggressive cancer, inflammatory breast cancer (IBC), accounts for one to five percent of all breast cancer diagnoses in the United States, according to BreastCancer.org. IBC is breast cancer in which the cancer cells block lymph vessels in breast skin causing redness and swelling. This reaction is due to the skin not receiving any lymph, which is the fluid that transports white blood cells to remove bacteria and proteins from the tissue.

What are the signs and symptoms of inflammatory breast cancer?

Unlike other forms of breast cancer, IBC has symptoms that appear quickly and can worsen rapidly within days or even hours in some cases. These symptoms include:

  • Breast skin redness
  • Breast swelling
  • Warm feeling on breast
  • Aching or burning feeling
  • Peau d'orange (the breast looks similar in appearance to a naval orange)
  • Changes in breast skin
  • Lymph node swelling noticeable near collarbone or under the arm
  • Flattened or inverted nipple

If you are experiencing any of these symptoms, or you have any breast cancer risk factors, you should contact your physician.

How is IBC diagnosed?

Since there are often more physical indications of IBC, you or your physician may notice a change in breast skin that will likely prompt further examinations and tests. The hardening of the skin that is common with IBC can often be felt by physicians and seen on mammograms. Since IBC grows in layers rather than in lumps, like other types of breast cancer, it is possible for it to be missed on a screening mammogram. Once an abnormality is seen through physical examination or on a mammogram image, your physician will use a biopsy to arrive at a diagnosis of IBC. After this diagnosis, your physician will need additional testing to discern how many lymph nodes are affected and if the cancer has spread to other body parts. The tests for this IBC diagnosis may include:

  • Chest X-ray
  • CT scan
  • Bone scan
  • Liver function tests

Once your physician has completed the diagnosis they will begin to stage your inflammatory breast cancer:

Stage IIIB:

Cancer has spread to tissues near the breast. It is common for this stage to spread to skin, ribs, or muscles in the chest. Additionally, the cancer may have spread to other lymph nodes within the breast and possibly under the arm.

Stage IIIC:

This stage of IBC indicates the cancer has spread to the collarbone lymph nodes and possibly lymph nodes within the breast and under the arm. Tissue surrounding the breast could also be affected.

Stage IV:

In this advanced stage, the IBC has spread to other organs (lungs, liver, brain, and bones are common places for this stage of IBC to spread to), as well as the lymph nodes in the neck.

How is inflammatory breast cancer treated at Baptist?

Each inflammatory breast cancer patient is unique, and thus requires a personalized approach to treatment plans. Baptist physicians use a combination of cancer treatments to effectively treat IBC.

Although surgery is still part of the treatment plan for IBC, it is common for your physician to start chemotherapy treatment prior to surgery. Sometimes targeted therapy is also used before surgery, if your cancer tested positive for HER2. Treating IBC this way helps shrink the cancer and lower swelling, making surgery less complicated. Before surgery, your physician will want to see that the cancer is responding to the chemotherapy and is shrinking. If your IBC has not changed or has worsened, your physician will put off surgery in favor of continuing chemotherapy or progressing to radiation therapy.

Due to the aggressive nature of IBC, surgery that preserves breast tissue is generally not recommended.

Following surgery, generally a mastectomy, your physician will start you on radiation therapy that targets any remaining cancer cells.