Inflammatory Breast Cancer

Topic Overview

What is inflammatory breast cancer?

Inflammatory breast cancer is a rare, fast-growing type of breast cancer. It is often called IBC for short.

Unlike other breast cancers, this type of cancer may not cause a lump in the breast. So regular breast exams and mammograms often fail to catch it early. Because it grows so fast, it usually has spread by the time it is diagnosed.

What causes inflammatory breast cancer?

In this type of cancer, the cancer cells often do not form lumps in the breast. Instead, the cancer cells block the lymph vessels that normally keep lymph fluid moving in the breast.

When the normal flow of lymph fluid is blocked, it can make the breast look swollen and red and feel warm, as if it were infected. The swelling may cause lots of tiny dimples in the skin. Sometimes it causes a lump that grows quickly, but you can have inflammatory breast cancer without having a lump in your breast.

What are the symptoms?

Inflammatory breast cancer can cause one or more of these symptoms:

• A breast that is swollen, red, and warm
• A breast that is tender or painful
• An area of itching in the breast
• A recent change in the nipple. Sometimes the nipple pulls back into the breast instead of pointing outward. This is called a retracted nipple.
• A change in the skin, especially an area that looks thick and pitted, like an orange peel. Sometimes there are ridges in the skin and small bumps that look like a rash or hives.
• An area of the breast that looks bruised
• Swollen lymph glands (lymph nodes) in the armpit
• One or more lumps in the breast

How is inflammatory breast cancer diagnosed?

A biopsy is needed to diagnose this cancer. During a biopsy, the doctor takes a sample of the breast or the breast skin. The sample is looked at in a lab to see if it contains cancer cells.

It's very important to diagnose inflammatory breast cancer quickly so that treatment can begin. But because it is rare and usually doesn't make a lump, doctors may not recognize the symptoms right away. The cancer is often mistaken for other problems, like spider bites, an allergic reaction, or mastitis, which is a breast infection that is usually treated with antibiotics.

Antibiotics do not help inflammatory breast cancer. If your doctor has given you antibiotics and your symptoms do not seem to be getting better after a week, call your doctor.

After a biopsy shows that you have this type of cancer, your doctor will order more tests-such as a mammogram, a bone scan, or a CAT scan -to see if the cancer has spread.

How is it treated?

It's very important to treat this cancer as soon as possible. And more than one type of treatment may be needed. Treatment starts with anticancer drugs, called chemotherapy. These drugs help shrink the cancer.

Some tests will be done to help find which medicines will work best for you. These tests look at cancer cells from your biopsy to find out what kind of cancer you have. These tests include:

• Estrogen and progesterone receptor status. The hormones estrogen and progesterone stimulate the growth of normal breast cells, as well as some breast cancers. Hormone receptor status is an important piece of information that will help you and your doctor plan treatment.
• HER-2 receptor status. HER-2/neu is a protein that regulates the growth of some breast cancer cells. About one-third of women with breast cancer have too much (overexpression) of this growth-promoting protein.

Chemotherapy is usually followed by surgery (mastectomy). During surgery, some of the lymph nodes are removed. Afterwards, most women have radiation therapy.

More chemotherapy or hormone therapy(or both) may be used after radiation, especially if cancer has spread to the lymph nodes.

Women who test positive for HER-2 may be treated with trastuzumab (Herceptin) during chemotherapy and afterwards.

Talk with your doctor about taking part in a clinical trial. Many women who have inflammatory breast cancer are good candidates for clinical trials, which study new treatments for IBC and better ways to use current treatments.

How do you cope with having inflammatory breast cancer?

Inflammatory breast cancer is a very serious disease. But there is reason for hope, because treatment is improving. These days, many women are still free of cancer, some even 15 years and longer.

Talking with others who have breast cancer can help. To find a support group, contact your local branch of the American Cancer Society.

You may want to talk with your doctor about whether you are a good candidate for genetic testing for breast cancer. This can help other members of your family to understand more about their risk of breast cancer.

Additional information about inflammatory breast cancer is provided by the National Cancer Institute at www.cancer.gov/cancertopics/factsheet/Sites-Types/IBC.