Inflammatory breast cancer differs from other breast cancer types in that it usually does not have a distinct lump or solid mass. With inflammatory breast cancer, cancer cells block the lymph vessels in the skin and soft tissues of the breast, causing the breast to become red and swollen. This makes inflammatory breast cancer difficult to diagnose. A prompt, accurate diagnosis of your symptoms and an appropriate treatment plan are the key to improving your chances of survival.
Inflammatory breast cancer is rare. It is the least common and most aggressive type of breast cancer. It accounts for only 2 - 4% of breast cancers, but results in 10% of U.S. breast cancer deaths. The median age of women who develop inflammatory breast cancer is younger than the age of women who develop other types of breast cancer.
This rare disease requires a team of breast cancer specialists who are experienced in treating it. We treat more inflammatory breast cancer patients than any center in eastern Wisconsin.
Some of the diagnosis and treatment challenges include:
- No stage I or II – IBC always presents as stage III or stage IV disease (advanced)
- Develops and grows rapidly within six months
- Often spreads to other parts of the body
- No identified risk factors for who is more likely to develop IBC
- Not hereditary but family history could increase risk
- Appears to occur more often in African-American women
Signs and Symptoms of Inflammatory Breast Cancer
Symptoms of inflammatory breast cancer can appear and progress rapidly. They include:
- Pain, tenderness or itching in the breast
- Breast feels unusually warm to the touch
- Redness and thickening of the breast skin
- A pitted appearance of the breast skin called peau d’orange (like the skin of an orange).
- A firmer, heavier feel of the affected breast in comparison with the unaffected breast
- Inverted nipple in the affected breast (in some cases)
IBC ConnectFroedtert & MCW inflammatory breast cancer (IBC) experts are members of a consortium developed by MD Anderson called IBC Connect. IBC Connect is made up of U.S. and international centers that specialize in treating inflammatory breast cancer. This means you have access not only to our inflammatory breast cancer experts but also to the expertise of all of IBC Connect’s specialists because our team can bring your case to the larger group for discussion and treatment recommendations whenever needed. It also means you will have access to clinical trials without having to travel far from home. Clinical trials can expand your treatment options.
Inflammatory Breast Cancer Testing and Diagnosis
Because inflammatory breast cancer is so rare and symptoms are similar to a breast infection, it can be a challenge to diagnose. Redness in the skin of the breast may lead a physician to suspect a breast infection such as mastitis and prescribe antibiotics, which can delay treatment for inflammatory breast cancer.
If your doctor prescribes antibiotics, and your symptoms do not improve within three days of taking the medication, you need to contact your doctor. Your doctor should suspect that there is cancer in the breast and immediately refer you to a team of physicians who specialize in treating inflammatory breast cancer.
If your physicians suspect inflammatory breast cancer, they will evaluate both breasts for the disease, using imaging that may include mammography, MRI and ultrasound. A breast-focused radiologist will take images that may show diffuse micro-calcifications, increased density of the entire breast tissue, enlarged lymph nodes or a large, ill-defined mass.
After imaging, your physicians may order a biopsy to evaluate small samples of your breast tissue and skin. If biopsy results confirm an inflammatory breast cancer diagnosis, you will need additional imaging to determine if the cancer has spread to other parts of your body. If you have any concerns about your diagnosis or proposed treatment, or just want to make sure you are on the right path, seek a second opinion.
Treatment for Inflammatory Breast Cancer
Because this type of cancer occurs throughout the breast, and does not stay within a confined area, it is important to treat it with chemotherapy first.
Chemotherapy. Chemotherapy is a systemic treatment, meaning it affects the entire body. The goal is to decrease the presence of cancer in your body before breast surgery.
Mastectomy. If the swelling in the breast decreases after chemotherapy, the next step is to surgically remove the entire breast and any affected lymph nodes. Because inflammatory breast cancer involves the entire breast, a lumpectomy is not possible.
Radiation therapy. Surgery is followed by radiation therapy to destroy any remaining cancer cells, control the disease and keep it from returning.
If swelling persists after chemotherapy, we forego surgery and move straight to radiation therapy, targeting the breast and the affected chest wall. After radiation therapy, your team will evaluate the results to determine if surgery is possible. After each treatment step, we stage the cancer to determine the extent and severity of the remaining disease.
Hormonal therapy. If your inflammatory breast cancer is hormone- or progesterone-receptor positive, your doctor may recommend hormone therapy in the form of a pill to stop your body from producing these hormones, as these hormones can cause your cancer to grow.
Targeted therapy. Depending on your cancer’s HER2 status, your physician may recommend targeted therapy. HER2 is a protein that exists on the outside of all breast cells. If your breast cancer has higher than usual levels of this protein, your cancer is known to be HER2-positive. This type of breast cancer can grow and spread faster than other types of breast cancer. If your cancer is HER2-positive, it is more likely to respond to therapies designed to target HER2 proteins.
Surviving Inflammatory Breast Cancer
Inflammatory breast cancer is a very aggressive, fast-moving disease with about a 50% survival rate. (Survival can range from 30-70%.) This survival rate tells you the percentage of people out of 100 who are alive at least five years after diagnosis.
To give yourself the best chance of survival, you need to be proactive. Always be aware of any changes in your breasts. When you do breast self-exams, in addition to your usual routine of feeling for breast lumps, compare the look and feel of each breast. Be aware of skin and nipple changes, redness, swelling or unusual firmness of the breast. If you have any of these symptoms, call your physician immediately. Arm yourself with knowledge to ensure you get an accurate diagnosis right away followed by prompt, expert treatment.
It is important to protect yourself against all forms of breast cancer by following recommendations including an annual mammogram beginning at age 40 for women at average cancer risk, and an annual breast exam by your provider.
An Experienced Inflammatory Breast Cancer Team
Our multidisciplinary inflammatory breast cancer team is made up of physicians who treat nothing else but breast cancer. The team includes specialists in medical oncology, surgical oncology, radiation oncology, breast radiology and even a breast-focused pathologist – all of whom are critical to accurately diagnosing, treating and monitoring inflammatory breast cancer. We are part of a collaborative group developed by MD Anderson called IBC Connect. This specialized group involves inflammatory breast cancer (IBC) experts from all over the U.S. and includes several international members.
Mammograms and the COVID-19 Vaccine – What You Should KnowSwelling of the lymph nodes is a known side effect of the COVID-19 vaccine. Although it is temporary and not harmful, these enlarged lymph nodes may be seen on your mammogram. Because swollen lymph nodes can indicate breast cancer, we may call you back for additional evaluation and possible follow-up imaging. To avoid this, please schedule your mammogram before your first COVID-19 vaccination or four weeks after your second-dose vaccination.
Virtual Visits Are Available
Safe and convenient virtual visits by video let you get the care you need via a mobile device, tablet or computer wherever you are. We’ll gather your medical records for you and get our experts’ input so we can offer treatment options without an in-person visit. To schedule a virtual visit, call 1-866-680-0505.
Cancer and the COVID-19 Vaccine
There is currently no data that suggests current or former cancer patients should avoid getting the COVID-19 vaccine. Cancer can weaken your immune system, so we recommend that most patients get the vaccine as soon as possible.