Early Signs of Inflammatory Breast Cancer

What Is Inflammatory Breast Cancer?

Inflammatory breast cancer is a type of breast cancer in which cancer cells block lymph vessels in the skin of the breast. It often causes the breast to look swollen and inflamed, which is why this type of breast cancer is known as inflammatory. It is rare, representing only 1% to 5% of all breast cancers diagnosed in the United States. IBC can be diagnosed in both women and men, but it is more common in women and usually is diagnosed later in men.

IBC is a rapidly progressing type of cancer, often advancing in weeks or months. Inflammatory breast cancer is different from other forms of breast cancer in several ways, including:

• It has different symptoms, including swelling, changes in the skin’s texture, and redness that aren’t common in other forms of breast cancer.
• It occurs more often in women under age 40, while other breast cancers mainly affect older women.
• It is more aggressive, growing, and spreading more quickly than other kinds of breast cancer.
• It can be harder to diagnose because it often doesn’t cause breast lumps, may not show up on a mammogram, and can be confused with breast infections.

Most cases of IBC arise from untreated invasive carcinomas within the breast. This means they originate in the cells that line the milk ducts of the breast, and then spread beyond the ducts.

Signs and Symptoms

Inflammatory breast cancer typically has different signs and symptoms than other, more-common forms of breast cancer. This is because the cancer cells block the lymph vessels in the breast skin, causing lymph fluid buildup and preventing the normal flow of lymph through the tissue. This can lead to several signs and symptoms that often develop quickly, within a span of three to six months. They include:

• Visible changes in the skin of the breast, such as redness, thickness, or swelling
• Discoloration of the skin, which can look red, pink, or bruised
• Tenderness, pain, or itchiness in the skin
• Pitting or thickening of the skin of the breast so that it may resemble an orange peel (peau d’orange)
• Retracted or inverted nipple
• One breast looks larger or feels heavier than the other
• One breast feels warmer than the other
• Swollen lymph nodes under the arms or near the collarbone

IBC usually is not detected until symptoms are present, so women should look for any changes in the breast and contact their gynecologist or primary care doctor promptly if they notice concerning signs. It’s also important to remember that although redness, swelling, and pain in the breast can be symptoms of inflammatory breast cancer, they can also be caused by other medical conditions, such as infections or injury.

Risk Factors and Causes

Risk factors for IBC include:

• Gender: Women have a much higher likelihood of developing IBC than men, although men can still develop it.
• Race: Black women are at greater risk for inflammatory breast cancer than white women.
• Age:Women who are younger than age 40 are more likely to be diagnosed with IBC than with other forms of breast cancer.
• Body weight:Women who are overweight or obese have a higher risk of inflammatory breast cancer than women who aren’t.
• Genetics:Women who have genetic mutations like BRCA1 (breast cancer gene one) or BRCA2 (breast cancer gene two) can have an increased risk of inflammatory breast cancer.

People with one or more risk factors should pay special attention to any signs or symptoms of potential IBC and contact their doctor if they notice them. However, just because a person has risk factors doesn’t mean he or she will develop the disease.

Inflammatory Breast Cancer Diagnosis

IBC is difficult to diagnose in its early stages because there are no lumps that indicate problems. By the time any concerning symptoms appear, breast cancer cells have grown into the skin, meaning the cancer is at least stage III when diagnosed. According to the Tumor, Node, Metastasis (TNM) staging system of the American Joint Committee on Cancer (AJCC), the following criteria must be met for a diagnosis of IBC:

• Rapid onset of breast erythema (redness), edema (swelling) and/or peau d’orange, and/or warm breast, with or without an underlying palpable mass
• Duration of history no more than six months
• Erythema occupying at least one-third of the breast
• Pathologic confirmation of invasive carcinoma

Oncologists use a range of tests to confirm an IBC diagnosis, including diagnostic mammograms, breast ultrasounds, breast MRIs, and biopsies (breast core biopsy and skin punch biopsy). In about one out of three cases, patients diagnosed with IBC are already at stage IV. This means the cancer has metastasized and spread to other areas of the body, making it more difficult to successfully treat.

Please note: Regional Cancer Care Associates does not offer early identification, screening, and evaluation of possible breast cancer. We accept referrals from physicians after patients have been diagnosed to provide them with high-quality cancer treatment  close to home. We also offer second opinions on diagnoses and treatment plans, if needed.

IBC Treatment Options

Once patients have been diagnosed with inflammatory breast cancer, they can work with their medical team to identify the most suitable treatment plan for them. Treatment options will vary depending on whether the cancer is stage III or IV. Because IBC is an aggressive form of cancer, multiple treatment options may be used together to offer the best outcome. These include:

• Chemotherapy: Chemotherapy is often the first-line treatment for IBC, using strong medicine to stop cancer cells from growing or reproducing.
• Surgery: Surgeons use procedures such as modified radical mastectomy and lymph node dissection to remove the cancer and any damaged tissue.
• Radiation therapy: Radiation therapy is often used after surgery, with high levels of radiation delivered to shrink or kill cancer cells that may not be seen during an operation.
• Hormone therapy: In cases of IBC where the cancer is hormone receptor-positive, hormone therapy can be used to target cancer cells and slow or stop their growth. However, most inflammatory breast tumors are hormone receptor-negative, which rules out hormone therapy.

Most inflammatory breast cancer guidelines recommend a tri-modality approach, using a combination of systemic therapy (chemotherapy), surgery, and radiation therapy to provide IBC patients with the best local control and survival outcome. Combining different treatment options for inflammatory breast cancer has significantly improved survival rates over the years.

Oncologists may also prescribe adjuvant therapy once the main treatment method is completed. This can be either chemotherapy, radiation therapy, or hormone therapy. Adjuvant therapy is given to help reduce the chances of the cancer coming back.

Frequently Asked Questions about Inflammatory Breast Cancer

Why is inflammatory breast cancer often diagnosed at a relatively late stage?

Patients diagnosed with IBC often wonder if the disease could have been caught earlier, but this generally isn’t the case with inflammatory breast cancer. Because IBC symptoms usually involve the skin, by the time they’re noticed, the cancer cells have already advanced locally and grown into the skin. This means IBC is only diagnosed after the disease has progressed to stage III or IV.

What is the outlook for inflammatory breast cancer?

IBC is the most aggressive type of breast cancer and is generally associated with a poor prognosis. In the United States, the five-year relative survival rate for inflammatory breast cancer is 40%. However, with tri-modality treatments, patients with inflammatory breast cancer have current overall five-year survival rates ranging from 30% to 70%. Survival rates have increased in recent years. Further, it’s important to remember that survival rates are only an estimation and do not dictate a specific individual’s survival.

Are there clinical trials available for inflammatory breast cancer?

Patients diagnosed with inflammatory breast cancer may benefit from participating in a clinical trial. A clinical trial is a study in which a new medicine, procedure, or device is tested in humans before it can be approved for widespread use. Clinical trials can give patients access to the latest innovations in treatment methods and medications while advancing research for inflammatory breast cancer.

Is breast reconstruction an option for patients with IBC?

Many women with breast cancer opt to undergo breast reconstruction surgery after a mastectomy. For patients with inflammatory breast cancer, there is a lot of skin involvement and treatment involves removing as much cancerous tissue as possible. Patients with IBC often are advised to wait at least six months after completing radiation before beginning reconstruction. Patients with IBC are also advised against using implant-based methods for reconstruction.

Cancer Treatment at Regional Cancer Care Associates

Regional Cancer Care Associates is a proud provider of comprehensive and compassionate medical care for patients throughout New Jersey, Connecticut, Maryland, and the Washington, DC, area. RCCA was established in 2012 after a merger of ten separate oncology practices with a mission of providing cutting-edge cancer and blood disorder treatment close to home. The oncology network has grown even further since then. Regional Cancer Care Associates:

• Offers innovative treatment options, such as targeted therapy and immunotherapy
• Uses state-of-the-art technology and cutting-edge processes
• Participates in more than 300 clinical trials
• Provide 20 conveniently located community-based locations throughout three states;
• Has 90+ cancer and blood disorder specialists
• Provides financial information, advocacy, and counseling services to patients
• Offers patient and caregiver education and patient advocacy services
• Provides cancer care support such as side effects management and active surveillance

Our dedication to providing our patients with not only high-quality medical care but also compassionate integrative services is one of the many reasons our patients come to us.

Request an Appointment Today

An inflammatory breast cancer diagnosis can be scary and overwhelming, but working with a medical team that offers both outstanding medical care and compassionate support can help you get through it. Regional Cancer Care Associates, with 20 locations throughout New Jersey, Connecticut, Maryland, and the Washington, DC, area, is a trusted source for world-class cancer care and patient support. Contact us to learn more about inflammatory breast cancer or request an appointment today.