Analyzing The Biopsy Sample
Analyzing the sample removed during the biopsy helps your doctor learn about specific features of a cancer and determine treatment options.
Your doctor may recommend additional laboratory tests on your tumor sample to identify specific genes, proteins, and other factors unique to the tumor. This helps your doctor find out the subtype of cancer.
Questions To Ask About Chemotherapy Hormonal Therapy Or Targeted Therapy
What is the goal of this treatment?
How long will it take to give this treatment?
Will I receive this treatment at a hospital or clinic? Or will I take it at home?
What side effects can I expect during treatment?
Who should I contact about any side effects I experience? And how soon?
What are the possible long-term effects of having this treatment?
What can be done to relieve the side effects?
How To Distinguish Ibc From Other More Common Conditions
It can be hard to distinguish breast changes caused by inflammatory breast cancer from other common conditions, such as an ordinary rash, allergic reaction, or infection. Thats why its important to see a health care provider as soon as you notice any of these changes to figure out the cause and get treatment, if necessary.
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What Are The Symptoms Of Inflammatory Breast Cancer
Symptoms of inflammatory breast cancer include swelling and redness that affect a third or more of the breast. The skin of the breast may also appear pink, reddish purple, or bruised. In addition, the skin may have ridges or appear pitted, like the skin of an orange . These symptoms are caused by the buildup of fluid in the skin of the breast. This fluid buildup occurs because cancer cells have blocked lymph vessels in the skin, preventing the normal flow of lymph through the tissue. Sometimes the breast may contain a solid tumor that can be felt during a physical exam, but more often a tumor cannot be felt.
Other symptoms of inflammatory breast cancer include a rapid increase in breast size sensations of heaviness, burning, or tenderness in the breast or a nipple that is inverted . Swollen lymph nodes may also be present under the arm, near the collarbone, or both.
It is important to note that these symptoms may also be signs of other diseases or conditions, such as an infection, injury, or another type of breast cancer that is locally advanced. For this reason, women with inflammatory breast cancer often have a delayed diagnosis of their disease.
Stage Iv Inflammatory Breast Cancer
- This stage refers to the spread of cancer to other organs
- These organs can include bone, liver, lungs, brain etc.
- Lymph nodes in the neck region may also be affected
Inflammatory breast cancer is a very rare type of cancer. This cancer does not develop as a lump but starts in the skin, making the breast swollen, red, tender and warm to touch. The breast may get an orange-peel appearance and there sometimes might be itching as well. It is a very rapidly growing form of cancer and hence, is usually diagnosed when the disease has already progressed to a later stage.
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Survival Rates For Inflammatory Breast Cancer
Inflammatory breast cancer is considered an aggressive cancer because it grows quickly, is more likely to have spread at the time its found, and is more likely to come back after treatment than other types of breast cancer. The outlook is generally not as good as it is for other types of breast cancer.
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.
Treatment Of Inflammatory Breast Cancer
Inflammatory breast cancer is an uncommon type of invasive breast cancer that typically makes the skin on the breast look red and feel warm. It also may give the breast skin a thick, pitted appearance that looks a lot like an orange peel. These changes are caused by cancer cells blocking lymph vessels in the skin.
Because inflammatory breast cancer has reached these lymph vessels and has caused changes in the skin, it is considered to be at least a stage III breast cancer when it is diagnosed. IBC that has spread to other parts of the body is considered stage IV. These cancers typically grow quickly and can be challenging to treat.
Regardless of the stage of the cancer, participation in a clinical trial of new treatments for IBC is also a good option because IBC is rare, has a poor prognosis , and these studies often allow access to drugs not available for standard treatment.
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Treating Stage Iii Inflammatory Breast Cancer
IBC that has not spread outside the breast or to nearby lymph nodes is stage III. Treatment usually starts with chemotherapy to try to shrink the tumor. If the cancer is HER2-positive, targeted therapy is given along with the chemo. This is typically followed by surgery to remove the cancer. Radiation therapy often follows surgery. Sometimes, more chemo may be given after surgery but before radiation. If the cancer is hormone receptor-positive , hormone therapy is given as well . Combining these treatments has improved survival significantly over the years.
How Is Inflammatory Breast Cancer Different From Other Types Of Breast Cancer
When compared to other forms of the disease, inflammatory breast cancer:
- Looks different — often there are no lumps, but your breast might appear red, swollen, or inflamed
- Is harder to diagnose — it doesnât show up well on a mammogram
- Is more aggressive and spreads more quickly than other types
- Tends to be diagnosed at a younger age, especially among African-American women
- Is more likely to affect overweight women
- Is often further along when itâs diagnosed
- Sometimes has spread past the breast when itâs diagnosed, which makes it harder to treat
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Staging Inflammatory Breast Cancer
Inflammatory breast cancer is always at least locally-advanced when its first diagnosed because the breast cancer cells have grown into the skin. This means it is at least stage III.
In about 30% of cases, the inflammatory breast cancer has already spread to parts of the body away from the breast when it is diagnosed. This means the cancer is metastatic or stage IV.
After inflammatory breast cancer is diagnosed, your doctor will do more tests to collect information on the characteristics of the cancer. These tests, as well as the results of your biopsy and any imaging tests, make up the parts of your pathology report.
Other information commonly collected on inflammatory breast cancer includes:
Survivorship care after inflammatory breast cancer treatment
Because of treatments theyve received, many breast cancer survivors have a higher risk of developing other diseases as they age, including high blood pressure, heart disease, and osteoporosis. To make sure breast cancer survivors are regularly screened for these and other diseases, experts have developed the idea of survivorship care planning.
Survivorship care plans are written documents made up of two parts.
The first part is a treatment summary, a record of all the breast cancer treatments youve received.
Can Inflammatory Breast Cancer Be Prevented
Unfortunately, there is no way to prevent IBC . Thats why, in an interview with Flo, breast surgical oncologist Dr. Carlie Thompson says that routine screening for breast cancer is important: It catches breast cancer in its earliest form. Carlie says that the majority of cases of breast cancer are diagnosed via breast cancer screenings, like mammograms. During a mammogram, an x-ray is taken of your breasts to look for abnormal findings that may signify cancer. Mammography can identify cancer years before it could be felt.
The American Cancer Society recommends that women aged 4554 get annual mammograms.
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Why Diagnosing Inflammatory Breast Cancer Is Hard And How To Overcome The Challenges: A Narrative Review
Huong T. Le-Petross1,2, Wintana Balema2,3,4, Wendy A. Woodward2,4
1 Department of Breast Radiology, The University of Texas MD Anderson Cancer Center, Graduate School of Biomedical Sciences , The University of Texas Health Science Center at Houston , Morgan Welch IBC Clinic and Research Program , The University of Texas MD Anderson Cancer Center Houston , 3 Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Graduate School of Biomedical Sciences , The University of Texas Health Science Center at Houston , 4 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Graduate School of Biomedical Sciences , The University of Texas Health Science Center at Houston , , USA
Contributions: Conception and design: WA Woodward Administrative support: WA Woodward, W Balema Provision of study materials or patients: HT Le-Petross, WA Woodward Collection and assembly of data: All authors Data analysis and interpretation: WA Woodward, HT Le-Petross Manuscript writing: All authors Final approval of manuscript: All authors.
Objective: The purpose of this narrative review is to summarize the contributors to misdiagnosis or delayed diagnosis of inflammatory breast cancer and strategies for expedient diagnosis.
Background: Patients with IBC often report the disease as initially being misdiagnosed, most commonly as mastitis.
Submitted Aug 31, 2021. Accepted for publication Dec 09, 2021.
How Inflammatory Breast Cancer Is Diagnosed
Breast imaging tests
- Diagnostic mammography. A diagnostic mammogram is an x-ray of the breast. An x-ray is a way to create a picture of the structures inside of the body using a small amount of radiation. It is similar to a screening mammography, which is used to look for a possible breast tumor in people who have no symptoms. A diagnostic mammography is often used when a person is experiencing signs, such as nipple discharge or a new lump. It may also be used if something suspicious is found on a screening mammogram.
- Ultrasound. An ultrasound uses high-frequency sound waves to create an image of the breast tissue. An ultrasound can distinguish between a solid mass, which may be cancer, and a fluid-filled cyst, which is usually not cancer.
- Magnetic resonance imaging . An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. An MRI can be used to measure the tumors size. A special dye called a contrast medium is given into the patients vein before the scan to help create a clear picture of the possible cancer. A breast MRI may be used after a diagnosis of breast cancer to check the other breast for cancer or to find out how much the disease has grown throughout the breast. It may also be used for screening, along with mammography, for those with a very high risk of developing breast cancer.
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How Do You Cope With Having Inflammatory Breast Cancer
Inflammatory breast cancer is a very serious disease. But there is reason for hope, because treatment is improving. These days, many women are still free of cancer, some even 15 years and longer.
Talking with others who have breast cancer can help. To find a support group, contact your local branch of the Canadian Cancer Society.
You may want to talk with your doctor about whether you are a good candidate for genetic testing for breast cancer. This can help other members of your family to understand more about their risk of breast cancer.
You can find more information about inflammatory breast cancer online at the:
- Canadian Cancer Society website at www.cancer.ca.
- U.S. National Cancer Institute website at www.cancer.gov.
Survival For Inflammatory Breast Cancer
Many factors can influence life expectancy for women with inflammatory breast cancer. These include:
- the exact position of the cancer
- how big the cancer is and whether it has spread only to the lymph nodes or to other organs
- how abnormal the cancer cells look under the microscope
- your age
- whether the cancer cells have receptors for hormone therapies
- how well the cancer responds to treatment
Inflammatory breast cancer can develop quickly and may spread to other parts of the body. So, in general, the outlook with this type is not as good as for women diagnosed with other types of breast cancer. But doctors think that the outlook is improving as breast cancer treatment improves.
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How Does The Test Work
The testing lab typically uses a specialized staining process on the breast tissue sample to see if hormone receptors are present. The technical name for this procedure is an immunohistochemical staining assay or an ImmunoHistoChemistry . Findings will be included in a pathology report given to your doctor. If the cancer is deemed estrogen-receptor-positive , its cells have receptors for the estrogen hormone. That means that the cancer cells likely receive signals from estrogen to promote growth. About two out of every three breast cancers contain hormone receptors.
If the cancer is progesterone-receptor-positive , its cells have receptors for progesterone. This hormone could then promote the growth of the cancer.
The cancer cells being estrogen and/or progesterone receptor-positive is a good prognostic factor to have, usually leading to a better prognosis.
When Should I Call My Doctor If I Am Concerned About Inflammatory Breast Cancer
If you notice any changes to your breast, even if you do not feel a lump, you should contact your doctor immediately. With further testing, your doctor can determine whether IBC may be a concern.
Last reviewed by a Cleveland Clinic medical professional on 10/27/2018.
- American Cancer Society. Inflammatory Breast Cancer. Accessed 11/1/2018.
- Breastcancer.org. Inflammatory Breast Cancer. Accessed 11/1/2018.
- The IBC Network Foundation. What is Inflammatory Breast Cancer? Accessed 11/1/2018.
- National Breast Cancer Foundation. Inflammatory Breast Cancer . Accessed 11/1/2018.
- National Cancer Institute. Inflammatory Breast Cancer. Accessed 11/1/2018.
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Stages Of Inflammatory Breast Cancer
This type of cancer is usually in one of three stages:
- Stage IIIB: All Inflammatory breast cancers start in this stage since they involve the skin of your breast.
- Stage IIIC: This cancer has spread to lymph nodes around your collarbone or inside your chest.
- Stage IV: The cancer has spread outside your breast and nearby lymph nodes to other parts of your body.
Tests For Diagnosis And Staging
To diagnose inflammatory breast cancer, your doctor will perform a biopsy. Biopsy is a surgical procedure that removes some of the suspicious breast tissue for examination under a microscope.
Because inflammatory breast cancer usually does not begin as a distinct lump, but instead as changes to the skin, a skin punch biopsy is often used to make the diagnosis. During this type of biopsy, the doctor uses a circular tool to remove a small section of the skin and its deeper layers, and then stitches the wound closed. If your doctor can see a distinct lesion, he or she may perform an ultrasound-guided core needle biopsy. Ultrasound is an imaging method that places a sound-emitting device on the breast to obtain images of the tissues inside. Guided by the ultrasound, the doctor inserts a hollow needle into the breast to remove several cylinder-shaped samples of tissue from the area of suspicion.
If the biopsy shows that inflammatory breast cancer is present, your doctor will order additional tests to figure out how much of the breast tissue and lymph nodes are involved, and whether or not the other breast is affected. Breast MRI, or magnetic resonance imaging, is considered the most reliable test for gathering more information about inflammatory breast cancer.
Once IBC is diagnosed, additional tests are used to determine whether the cancer has spread outside the breast to other organs, such as the lungs, bones, or liver. This is called staging. Tests that may be used include:
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Questions To Ask About Choosing Treatment And Managing Side Effects
What are my treatment options?
What clinical trials are available for me? Where are they located, and how do I find out more about them?
What treatment plan do you recommend? Why?
What are the chances that the cancer will be successfully treated?
Who will be part of my health care team, and what does each member do?
Who will be leading my overall treatment?
What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?
What are the possible side effects of this treatment, both in the short term and the long term?
How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?
Could this treatment affect my sex life? If so, how and for how long?
Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?
If Im worried about managing the costs of cancer care, who can help me?
How can I keep myself as healthy as possible during treatment?
How can I learn more about this specific type of breast cancer?
What support services are available to me? To my family?
If I have questions or problems, who should I call?
Surgery And Further Treatments
If the cancer improves with chemo, surgery is typically the next step. The standard operation is a modified radical mastectomy, where the entire breast and the lymph nodes under the arm are removed. Because IBC affects so much of the breast and skin, breast-conserving surgery and skin-sparing mastectomy are not options. It isnt clear that sentinel lymph node biopsy is reliable in IBC, so it is also not an option.
If the cancer does not respond to chemo , surgery cannot be done. Either other chemo drugs will be tried, or the breast may be treated with radiation. Then if the cancer responds , surgery may be an option.
If breast radiation isnt given before surgery, it is given after surgery, even if no cancer is thought to remain. This is called adjuvant radiation. It lowers the chance that the cancer will come back. Radiation is usually given 5 days a week for 6 weeks, but in some cases a more intense treatment can be used instead. Depending on how much tumor was found in the breast after surgery, radiation might be delayed until further chemo and/or targeted therapy is given. If breast reconstruction is to be done, it is usually delayed until after the radiation therapy that most often follows surgery.
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