Inflammatory Breast Cancer

Inflammatory breast cancer, or IBC, is a rare form of breast cancer. It is estimated to occur in only 1 - 3% of all breast cancer patients. It usually occurs in post-menopausal women, but cases have been found in girls as young as 12 and in men. IBC is usually diagnosed at an earlier age than other forms of breast cancer and is more common in African American women than in Caucasian women. This cancer has a higher mortality rate because it is often misdiagnosed in the early, more treatable stages. However, advances in cancer research have improved the survival rate.
This cancer grows rapidly; your symptoms will appear in a matter of days or weeks. Women with inflammatory breast cancer often have no idea that they have breast cancer because IBC does not usually form a lump in the breast. Instead, this cancer forms 'sheets' of cancer cells making your breast feel thicker or heavier than usual. Other symptoms of IBC include swelling and tenderness of the breast, discoloration (usually red to purple) of the breast, itching or pain in the breast, dimpled or rough looking skin on the breast, swelling or crusting of the skin on the nipple and flattening or retraction of the nipple. Many of these symptoms mimic those of a breast infection, or mastitis. Mastitis usually causes a fever and usually occurs in younger breast-feeding mothers. Mastitis will respond to antibiotics. IBC, which has been documented in breast-feeding women, does not cause a fever nor respond to antibiotics.
Because the symptoms of IBC are so similar to mastitis and because inflammatory breast cancer is so rare, many doctors misdiagnose this cancer as mastitis. Patients are often prescribed multiple rounds of antibiotics because it doesn't clear up after the first round. If you have these symptoms and your doctor wants you to take more than one round of antibiotics, ask for a biopsy or referral to a breast specialist. You may have to be very aggressive to get the proper diagnosis. This is vital because the earlier this is diagnosed, the sooner you can begin treatment and the better your survival chances.
A proper cancer diagnosis usually results from elimination of mastitis as a culprit, with the symptoms still present and possibly getting worse. Your doctor may schedule you for a mammogram or a breast sonogram to confirm the diagnosis, but these are not very reliable with this cancer because the affected area may not show up. A biopsy is the most effective way to confirm diagnosis of this cancer, however it may still be wrong if your doctor biopsies the wrong area of your breast. Because this cancer does grow very rapidly, your doctor may also schedule other tests to determine if your cancer has spread to other organs in your body. This will affect your course of treatment.
Your treatment depends largely upon whether your cancer has spread to other organs of your body. You will most likely have a team of doctors talking with you, trying to determine the best course of treatment for you. You will receive aggressive treatment because inflammatory breast cancer is a late stage cancer. This means you will most likely receive chemotherapy, surgery and radiation therapy. You will most likely receive chemotherapy first because this cancer makes performing surgery first risky due to the skin changes it causes. Chemotherapy also works to shrink the size of the cancer, making it more likely that surgery will remove all of it. The surgery that most women choose with this cancer is a mastectomy, or complete removal of the affected breast. This is because the cancer is often widespread throughout the breast, making a surgery that preserves breast tissue highly unlikely.
During surgery, your surgeon will probably remove the lymph nodes under your arm to examine them for cancer. After surgery, you will most likely receive radiation therapy. Radiation therapy is used to kill any cancer cells that the surgeon may have missed and to help prevent the cancer from returning. Inflammatory breast cancer has a high incidence of recurrence, so your doctor may prescribe additional rounds of chemotherapy if you responded well to the previous rounds or hormone therapy if your cancer was the type that grew in the presence of estrogen.