What is inflammatory breast cancer?
Inflammatory breast cancer is a rare form of breast cancer that accounts for between one and five percent of all breast cancers in the United States. It’s an aggressive form of cancer that progress quickly. It is called inflammatory breast cancer because it tends to make the breasts look red, swollen and inflamed.
When someone has inflammatory breast cancer, the cancer cells block the lymph vessels in the skin of the breast. While most breast cancers have four or five stages, inflammatory breast cancer is either stage IIIB or stage IV. If the cancer cells have spread to the lymph nodes but not elsewhere in the body, it’s stage IIIB. If they’ve spread beyond the lymph nodes, it’s stage IV.
Inflammatory breast cancer is different from other types of breast cancer in several ways. For example:
- It is often diagnosed at a younger age than other types of breast cancer
- It is more common in women of African American heritage than it is in white women
- The tumors are most often hormone-receptor negative and cannot be treated with hormone therapies to help stop cell growth
- It is more common in women who are clinically obese
Like most other types of breast cancer, it can also develop in men.
What causes inflammatory breast cancer?
Doctors are not sure what causes inflammatory breast cancer, but they do know it begins with an abnormal cell in a breast duct. Then mutations within the DNA of that abnormal cell tell the cell to grow and divide, which leads to an accumulation of cells in the lymphatic vessels within the breast skin. The cells cause a blockage, which leads to breast skin that appears red, swollen, or dimpled/puckered.
What are the symptoms of inflammatory breast cancer?
The most common signs and symptoms of inflammatory breast cancer are:
- breast swelling
- breast redness
- discoloration of the skin of the breast – it may appear pink, reddish, or bruised
- pitting or ridges in the breast (like the skin on an orange)
- rapid increase in breast size
- a heavy feeling in the breast
- breast tenderness
- inverted nipple
- swollen lymph nodes around the breast, like under the arm or near the collarbone
Many of these symptoms may be signs of other conditions, so they can be overlooked or misdiagnosed. For this reason, it’s important to advocate for yourself. If you have signs or symptoms of inflammatory breast cancer, see your doctor right away, and ask for tests. This is especially important because of the quick progression of this type of cancer.
Diagnosing inflammatory breast cancer
Diagnosing inflammatory breast cancer can be difficult. Because most people with inflammatory breast cancer do not develop a breast lump, it may not be found during a breast exam or a screening mammogram. Most women who are diagnosed with inflammatory breast cancer also have dense breast tissue, which makes both screening and detection more difficult. Because inflammatory breast cancer can be mistaken for mastitis (a breast infection) or other forms of breast cancer and because it grows so rapidly, many women are not diagnosed until the cancer cells have spread to other parts of the body.
A panel of expert clinicians published guidelines to help doctors diagnose inflammatory breast cancer properly. The minimum criteria for an inflammatory breast cancer diagnosis are:
- rapid onset of breast redness, swelling, pitting or ridging of the skin, and/or abnormal breast warmth – with or without a palpable breast lump
- symptoms have been present for less than six months
- redness covers at least one third of the breast skin
- a biopsy shows invasive carcinoma
Additional testing should also be done to check whether the cancer cells are hormone-receptor positive or if they have more than the normal amounts of the HER2 protein or HER2 gene.
Imaging tests may be done to aid in the diagnosis, including:
It’s important that you seek treatment from a doctor who is experienced with diagnosing and successfully treating inflammatory breast cancer.
How do you treat inflammatory breast cancer?
Most breast cancer specialists will treat inflammatory breast cancer with a combination of systemic chemotherapy followed by surgery and radiation. The chemotherapy is done to help shrink the cancer growth prior to removing as much as possible with surgery. Then doctors administer radiation therapy to help kill any cancer cells that remain after surgery.
Treatments may include:
- Neoadjuvant chemotherapy (chemotherapy before surgery) to shrink the cancer cells
- Targeted therapy to target HER2 proteins that are often produced by the breast cancer cells
- Hormone therapy if the breast cancer cells contain hormone receptors; this helps block the effects of estrogen on cells or blocks the body’s ability to make estrogen
- Surgery to remove the affected areas of the breast(s); the most common surgery for inflammatory breast cancer is a modified radical mastectomy, which is removal of the entire affected breast and all lymph nodes under the nearest arm; doctors may also remove the lining over the chest muscles, but preserve as much of the chest muscles as possible
- Radiation therapy after surgery to help kill remaining cancer cells
Beaumont’s Comprehensive Breast Care Program
The Comprehensive Breast Care Program at Beaumont Hospitals integrates cancer prevention, early detection, rapid diagnosis, leading-edge therapies, and several support, education, and community-support programs. For an expedited and comprehensive breast evaluation, call 888-924-9460.