How Does Inflammatory Breast Cancer Start

Clinical Symptoms Of Inflammatory Breast Cancer

The symptoms of inflammatory breast cancer are not typical symptoms of breast cancer. Indeed, the symptoms are very similar to breast mastitis or a breast infection.

The Symptoms include:-

• Skin Changes: Patches of skin on the breast appear red or pink in color, or appear bruised
• The texture of the affected area of the breast may also change and appear dimpled or pitted, a little like the skin of an orange
• Itchy breasts: Itchiness around the affected area can occur
• Swelling of the breast: You may notice that one breast is larger than the other
• Breast pain: The affected breast may be tender, painful or feel heavier
• The breast feels hot to the touch or there can be a burning sensation
• Ridges or welt like marks may appear on the skin
• Inverted nipple, dimpling or flattening of the nipple
• Nipple Discharge
• Swollen lymph nodes under the arm or in the neck

Women with inflammatory breast cancer will typically present to a physician with a rapidly progressing, firm, tender, and enlarged breast. If you have even a small patch of inflamed, red skin on breast self-exam it is important to see your physician straight away.

Notably, women with inflammatory breast cancer will tend not to have a fever. Because it is a cancer that spreads very rapidly into and around the breast tissue, women with IBC might present with axillary adenopathy . This can be a sign that cancer has spread .

Hormone Receptor Status And Her2 Status

Triple negative IBC are hormone receptor-negative and HER2-negative. Triple negative IBC and IBC that are hormone receptor-positive and HER2-negative tend to have a worse prognosis than other IBC .

Hormone receptor-negative breast cancers, such as triple negative IBC, can be treated with chemotherapy, but they cant be treated with hormone therapy.

HER2-positive breast cancers can be treated with chemotherapy and with trastuzumab and other HER2-targeted therapies. So, women with HER2-positive IBC tend to have better survival than women with HER2-negative IBC .

Causes Of Inflammatory Breast Cancer

The causes of inflammatory breast cancer are unclear. Despite its name, inflammatory breast cancer is not actually caused by inflammation. Instead, the term inflammatory refers to the appearance of the breasts. The most common signs and symptoms of the condition redness, swelling and changes in skin texture are very similar to those that usually accompany an infection, injury or irritation that leads to increased blood flow and the buildup of white blood cells in the bodys tissues . However, when inflammatory breast cancer is present, these symptoms develop as cancer cells block lymph vessels in the breast skin.

Although the exact causes of inflammatory breast cancer are unclear, it is understood that the cancer can develop as follows:

• Inflammatory breast cancer begins with an abnormal cell that develops in a milk duct.
• Due to mutations in its DNA, the abnormal cell grows and divides at a very rapid pace.
• The resulting accumulation of cancer cells can clog the lymph vessels in the breast skin and inhibit lymphatic drainage, allowing fluids to build up within the breast.
• Sometimes, the cancerous cells metastasize, or spread, to lymph nodes, tissues and organs throughout the body.

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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.

References

• 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.

What Can Skin Changes On The Breast Mean

It can be scary to spot a change in your breasts, but if you notice that the skin of your breast is red, swollen, or warm, theres usually no reason to worry. Breast skin can be quite sensitive, so there are lots of common conditions and causes for breast skin changes, and the vast majority are not too much of a concern.

Some of the most common causes include:

Although most of the causes of a rash on the breast arent much to worry about, its important to be aware of the signs and symptoms of more serious conditions.

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Quick Facts About Inflammatory Breast Cancer

• IBC doesn’t look like other breast cancer.
• There usually isn’t a lump.
• It doesn’t always show up on a mammogram.
• IBC is more aggressive and is almost always “locally advanced” when diagnosed. One-third of patients have metastatic cancer at diagnosis.
• It’s more common in black women, whereas other breast cancers are more common in white women.
• IBC occurs more often in overweight or obese women.
• IBC can be mistaken to be mastitis, a breast infection usually seen in women who are nursing.
• IBC is a not a new disease IBC was first identified and described in 1814 by Sir Charles Bell.
• Black women are at higher risk for IBC.
• Men can also develop IBC.

What Is The Outlook For People Diagnosed With Inflammatory Breast Cancer

The outlook for people diagnosed with IBC depends on several factors including age and overall health, the extent to which the cancer has spread, and the timing of the diagnosis. In most cases, the earlier the diagnosis and sooner treatment begins, the better the prognosis.

Outcomes are usually best in patients who receive what is called trimodal treatment that involves chemotherapy, surgery, and radiation. After treatment, patients should follow up with their doctors to keep an eye on recurrence of breast cancer.

But because IBC is aggressive, it has a worse prognosis than most other types of breast cancer. Whats more, because it progresses rapidly, it is often diagnosed after the cancer has spread to nearby lymph nodes or distant parts of the body, which make effective treatment more difficult.

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Sudden Change In Breast Size

IBC can change the appearance of the breasts. This change can occur suddenly. Because this cancer can cause inflammation and swelling, breast enlargement or thickness can occur.

The affected breast may appear noticeably larger than the other breast or feel heavy and hard.

If youve always had symmetrical breasts and you notice a sudden increase or decrease in the size of one breast, speak with your doctor to rule out IBC.

You may be familiar with the fact that there are different stages of breast cancer. These stages are used to reflect how far the cancer has progressed.

At the time of diagnosis, all cases of IBC are either at stage 3 or stage 4:

• Stage 3. In stage 3 IBC, the cancer has spread to some of the tissues surrounding the breast. This can include nearby lymph nodes, the skin of the breast, and the tissues of the chest wall.
• Stage 4. In stage 4 IBC, the cancer has spread to more distant areas of the body, such as the lungs, liver, or bones. This is called metastasis. According to the ACS, its estimated that IBC has metastasized in

diagnostic criteria for IBC include:

• breast redness, swelling, dimpling, or warmth that comes on quickly, with or without a detectable lump or mass
• redness that includes at least a third of the breast
• symptoms that have lasted for no longer than 6 months
• confirmation of the presence of cancer cells through a biopsy

Now lets explore the diagnostic methods that can be used for IBC in a little more detail.

What Is A Breast Made Of

Both men and women have breasts, but women have more breast tissue than men.

The female breast is made of different components, including:

• lobules, which produce breast milk
• ducts, which carry milk to the nipple
• fatty tissue and connective tissue, which surround the lobules and ducts.

All breasts contain fatty and fibrous tissue. Lobules can also be referred to as glandular tissue. The male breast has ducts but few or no lobes or lobules.

Breast tissue extends from the collarbone to lower ribs, sternum and armpit.

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Mortality Rates And The Good News

In the past, IBC has a poor survival rate. Indeed, the 5-year overall survival rate was less than 5% with a median rate of just 15 months. One of the reasons for the low survival rate is that IBC is often at a late stage at the diagnosis.

Sadly, IBC has often already spread to the lymph nodes on diagnosis.

However, according to a more recent research study, over the last 30 years survival rates for IBC have improved significantly. The 15 year survival rate is now around 20% to 30%.

Specialists believe that the improvement in survival rates for breast cancer is due to changes in treatment.

These changes include:-

• Preoperative chemotherapy surgery
• Radiation treatment.
• An improvement in the understanding of IBC on a molecular level over the last ten years.

In addition, a 2015 study compares survival trends of women with inflammatory breast cancer before and after the year 2006. The 3-year survival rate for those treated for IBC before October 2006 was around 63%. In comparison, for cases of IBC after 2006 the 3-year survival rate has risen to 82%.

The above statistics, are again, a testimony to the improvement in targeted treatment, in this case, particularly HER-2 therapy.

Dog Breast Cancer: Diagnosis

Early detection of mammary masses is vital to your dogs correct diagnosis and treatment.

Before the diagnostic process begins, your veterinarian will ascertain whether your dog has recently given birth or gone through a heat cycle.

Mammary gland hyperplasia produces lumps around the time of a female dogs heat cycle. Hyperplasia is caused by hormonal imbalance . It typically dissipates once the hormones return to their usual concentration.

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How Does Inflammatory Breast Cancer Differ From The More Common Types Of Breast Cancer

Inflammatory breast cancer got its name because the symptoms suggest an infection in the breast pain, redness, swelling, and tenderness in the affected breast. However, treatment with antibiotics does not help relieve the discomfort or redness.

IBC is more aggressive because once the cancer cells develop within the milk ducts, they invade the breast’s lymph vessels. Then, the cancer cells can spread into the lymph nodes and eventually spread into other parts of the body.

When breast cancer spreads to other parts of the body, it is called metastatic breast cancer . With inflammatory breast cancer, cancer can spread in just months or, occasionally, in just weeks. That’s why it’s so important to recognize the symptoms and see a breast care professional immediately.

When To Consider Joining A Clinical Trial

If youre newly diagnosed with IBC, consider joining a clinical trial before starting treatment. For most people, treatment doesnt usually start right after youve been diagnosed. So, theres time to look for a clinical trial.

Once youve begun treatment for IBC, it can be hard to join a clinical trial.

BreastCancerTrials.org in collaboration with Susan G. Komen® offers a custom matching service to help find clinical trials that fit your health needs, including trials for people with IBC.

Learn more about clinical trials.

*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date.

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Whats The Outlook For Inflammatory Breast Cancer

This type of cancer is aggressive and is likely to have spread by the time itâs discovered. Itâs also more likely to come back than other types. Still, every case of cancer is unique. Your outlook depends on many things, like your overall health, the stage at which you were diagnosed, the treatment you got, and how your body responded to it.

According to the National Cancer Instituteâs Surveillance, Epidemiology, and End Results database, survival rates for inflammatory breast cancer by stage at diagnosis are:

• Stage III: About 57 months
• Stage IV: About 21 months

Itâs important to keep in mind that these numbers are based on people who were diagnosed years ago. Better treatments available now mean people getting diagnosed and treated today have a longer life expectancy.

How Is Inflammatory Breast Cancer Diagnosed And Treated

A diagnosis of inflammatory breast cancer is classified as Stage 3 breast cancer and is diagnosed through your physicians clinical judgment and a biopsy. A biopsy for inflammatory breast cancer is a biopsy of the skin of the breast.

If the pathology results show that the skin and dermal lymphatics of the breast skin contain breast cancer cells, this confirms it is inflammatory breast cancer.

Typically, IBC grows rapidly and requires aggressive treatment. This is the only type of breast cancer that requires urgent treatment, beginning with chemotherapy. Most oncologists recommend both local treatment of the affected breast and systemic treatment .

Surgery, radiation therapy, chemotherapy and hormone treatments may be included in the regimen. With aggressive treatment, the survival rate for inflammatory breast cancer patients has improved significantly in recent years.

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Inflammatory Breast Cancer: The Diagnosis

So, frequently in the diagnosis of IBC a PET scan is utilized.

Furthermore, larger sample excisional biopsies are often necessary. A skin biopsy can find evidence of invasive breast cancer cells, but this is not always the case.

Inflammatory breast cancer has a tendency to grow in layers, so it may be quite a while before a palpable lump actually appears. Furthermore, if a lump develops it might appear quite suddenly.

Around 30% of inflammatory breast cancers never develop an actual breast lump.

Recent studies have pointed to the potential advantages of new diagnostic techniques, such as fluorodeoxyglucose positron emission tomography .

Symptoms Causes Risks & Treatment

Inflammatory breast cancer is a rare and aggressive type of breast cancer. About 1% of breast cancer cases in the United States are this form of the disease. It is different than other breast cancers in its symptoms and prognosis. It also tends to affect women at a younger age than other breast cancers. Its called inflammatory because tumor cells block the lymphatic drainage pathways in the breast, causing the affected area of breast to become red, swollen, and tender. Physicians may initially suspect a breast infection however, it does not respond to antibiotics. Women at highest risk of developing IBC are those who are overweight and African American.

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What Does A Mammogram Show

A mammogram is a test used to examine the inside of the breasts, using a low dose X-ray. A trained clinician can interpret the images to identify any abnormal areas, masses or calcium deposits that may or may not indicate breast cancer. Mammograms performed on women who have no signs or symptoms of breast cancer are called screening mammograms. Mammograms that used to evaluate an abnormal breast symptom are called diagnostic mammograms.

Factors Associated With More Rapid Spread

Some types of breast cancer, as well as their subtypes, are more likely to spread than other types. For example, ductal carcinoma is more likely to spread than lobular carcinoma, among tumors that are the same size and stage.

Many breast cancers do not spread to lymph nodes until the tumor is at least 2 cm to 3 cm in diameter. Some types may spread very early, even when a tumor is less than 1 cm in size.

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When To Euthanize A Dog With Breast Cancer

Putting a beloved pet to sleep is never easy but must be considered once mammary cancer has spread or progressed too far.

If your pet shows any of the following signs, you may need to discuss possible euthanization with your veterinarian:

• Refusal to eat for extended periods
• Continual vomiting or diarrhea
• Lethargy
• Difficulty moving

If you notice any drastic negative change in your dogs behavior, monitor them carefully and consult your vet to discuss your options.

How Is Inflammatory Breast Cancer Diagnosed

Inflammatory breast cancer can be difficult to diagnose. Often, there is no lump that can be felt during a physical exam or seen in a screening mammogram. In addition, most women diagnosed with inflammatory breast cancer have dense breast tissue, which makes cancer detection in a screening mammogram more difficult. Also, because inflammatory breast cancer is so aggressive, it can arise between scheduled screening mammograms and progress quickly. The symptoms of inflammatory breast cancer may be mistaken for those of mastitis, which is an infection of the breast, or another form of locally advanced breast cancer.

To help prevent delays in diagnosis and in choosing the best course of treatment, an international panel of experts published guidelines on how doctors can diagnose and stage inflammatory breast cancer correctly. Their recommendations are summarized below.

Minimum criteria for a diagnosis of inflammatory breast cancer include the following:

• A rapid onset of erythema , edema , and a peau d’orange appearance and/or abnormal breast warmth, with or without a lump that can be felt.
• The above-mentioned symptoms have been present for less than 6 months.
• The erythema covers at least a third of the breast.
• Initial biopsy samples from the affected breast show invasive carcinoma.

Imaging and staging tests include the following:

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