Inflammatory breast cancer (IBC)

Inflammatory breast cancer (IBC) is a rare form of cancer. Unlike other types of breast cancers, IBC typically doesn’t have a distinctive lump or mass. IBC is also a form of aggressive breast cancer. It can also be mistaken for an infection.

You might experience redness, swelling and warmth in the affected breast. Early on, you might even see a rash. Because these symptoms mimic an infection, inflammatory breast cancer can be misdiagnosed at first.

Our breast cancer specialists at Aurora Breast Centers are here for you every step of the way. We provide genetic testing, the latest diagnostic tests and treatments for angiosarcoma.

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How rare is inflammatory breast cancer?

While less common, accounting for only 1% to 5% of all breast cancers, inflammatory breast cancer is a more aggressive form of the disease. It's even rarer in men, though when it does occur, it typically affects older men.

Early detection through self-exams is critical for better outcomes. Because it doesn't always show up as a lump, mammograms might not be the most effective detection method. If you notice any changes in your breast, like redness, swelling or warmth, talk to your doctor right away. Early diagnosis and prompt treatment are essential for improving your chances of a successful outcome.

Risk factors for inflammatory breast cancer

Just like other breast cancers, inflammatory breast cancer can be influenced by a mix of genes, environment and your lifestyle.

While some risk factors overlap with regular breast cancer, there are a few that seem more specific to inflammatory breast cancer, including:

• Age: Inflammatory breast cancer tends to happen more in younger women under 50.
• Family history: Having a family history of breast cancer or certain gene mutations can play a role. However, most cases of inflammatory breast cancer occur in women without a family link.
• Hormones: Factors like early periods, late menopause and hormone replacement therapy might elevate your risk.
• Childbirth and breastfeeding: Never giving birth, having your first child later in life or not breastfeeding might be slight risk factors. On the other hand, breastfeeding may lower your risk of breast cancer.
• Prior radiation therapy: Having radiation treatment on your chest could increase your risk of inflammatory breast cancer later in life.

Symptoms of inflammatory breast cancer

IBC is a type of breast cancer called invasive ductal carcinoma (IDC). It has a unique set of symptoms that develop quickly, often over weeks or even days.

Common IBC symptoms may include:

• Redness and warmth: The affected breast might appear reddish or pink and feel warmer to the touch compared to the other side.
• Swelling and enlargement: You might notice a significant difference in size between your breasts, with the affected breast being noticeably swollen and enlarged.
• Skin changes: The skin on the affected breast might become thickened, with a dimpled or pitted texture resembling an orange peel. It could also appear ridged or uneven.
• Breast pain or tenderness: While not always present, you might experience some pain or tenderness in the affected breast.
• Inverted nipple or other nipple changes: The nipple on the affected breast may turn inward, become flattened or appear retracted. You may also notice other changes like scaling or discharge.
• Rapid onset: Unlike other breast cancers where symptoms develop gradually, inflammatory breast cancer symptoms tend to appear quickly.

Stages of inflammatory breast cancer

Once diagnosed, your doctor will use a process called staging to determine how far the cancer has spread. This information is vital for creating the most effective treatment plan for you.

Breast cancer staging typically goes from 0 (carcinoma in situ, a non-invasive stage) to IV (metastatic cancer, where the cancer has spread beyond the breast). Lower stages indicate the cancer is more contained, while higher stages suggest it has spread further. Generally, lower stages have better survival rates.

With inflammatory breast cancer, it's important to note that it's usually diagnosed at a later stage (typically stage 3 or 4) because it doesn't develop a noticeable lump.

Diagnosing inflammatory breast cancer

Diagnosing inflammatory breast cancer involves a combination of exams, imaging tests and biopsies. Given its aggressive nature, your doctor will work with breast cancer specialists to confirm the diagnosis and develop the best treatment plan for you.

Your doctor will discuss your medical history, any risk factors you may have and any symptoms you're experiencing. They'll also perform a physical exam of your breasts.

Imaging tests such as mammograms, breast ultrasounds and MRIs are often used to get a clearer picture of what's happening inside your breasts.

A biopsy is essential to confirm a diagnosis of inflammatory breast cancer. This usually involves removing a small tissue sample from the affected breast or nearby lymph nodes for examination under a microscope.

There are different types of biopsies, and your doctor will recommend the most suitable one for your situation, including:

• Core needle biopsy: A hollow needle is used to extract a small sample of tissue from the breast.
• Fine needle aspiration (FNA): A thin needle is used to withdraw cells from the breast for analysis.
• Surgical biopsy: In some cases, a surgical procedure may be performed to obtain a larger tissue sample for analysis.

A pathologist will examine the tissue sample obtained from the biopsy to identify characteristic features of the cancer cells and to confirm the presence of inflammatory breast cancer.

Once a diagnosis is confirmed, additional tests might be needed to determine the stage of the cancer, which is crucial for determining your personalized treatment plan and understanding your prognosis.

Treatment for inflammatory breast cancer

Since inflammatory breast cancer is aggressive and often diagnosed at a later stage, your doctor will recommend a comprehensive treatment plan that combines different therapies to target your cancer effectively.

Treatment options may include:

• Chemotherapy: This treatment is often the first line of defense, especially for aggressive cancers. It's administered before surgery to shrink the tumor and slow its spread.
• Surgery: Surgery is the main treatment for IBC. Depending on the extent of the cancer, options may include a lumpectomy (partial removal) or a mastectomy (complete removal) of the breast tissue. Lymph node removal might also be necessary.
• Radiation therapy: After surgery, radiation therapy is often used to destroy any remaining cancer cells and reduce the risk of recurrence.
• Targeted therapy: If your cancer cells have specific molecular targets, your doctor might recommend targeted medications that can disrupt the growth and spread of cancer cells.
• Hormone therapy: In some cases, hormone therapy can be beneficial by blocking estrogen, which fuels the growth of certain types of breast cancer.
• Supportive care: Throughout your treatment journey, your care team will provide supportive services such as palliative care, nutritional guidance, pain management and physical therapy to address the physical and emotional challenges that come with cancer treatment.