Symptoms Of Inflammatory Breast Cancer
Because the lymph channels are blocked, the breast might become:
- hot to the touch
The breast can also be painful in inflammatory breast cancer, but this is not always the case.
Other possible symptoms include:
- ridges or thickening of the skin of the breast
- pitted skin, like orange peel
- a lump in the breast
- a discharge from the nipple
- an inverted nipple the nipple is pulled into the breast
Inflammatory breast cancer symptoms can appear quite suddenly.
Inflammatory breast cancer is often confused with an infection of the breast . This is because the symptoms are very similar. Mastitis is uncommon in women who arent pregnant or breast feeding and it is particularly rare in women who have had their menopause.
Your doctor might give you a course of antibiotics if they think that you could have mastitis. But they will refer you to a specialist if they think you are unlikely to have an infection or if your symptoms dont clear up after antibiotics.
While inflammatory breast cancer can cause these particular symptoms, its worth being aware of the general symptoms of breast cancer.
Make an appointment to see your doctor if you notice any change in the look or feel of your breasts.
Your GP usually refers you to a breast clinic for tests.
You might have a:
- mammogram, which is an x-ray of the breast
- breast ultrasound
- biopsy of the skin in the breast
- biopsy of a breast lump
- MRI scan of the breast
Other tests may include a CT scan or PET-CT scan, and bone scan
How Does Staging Relate To Types Of Breast Cancer
In addition to cancer stage, doctors will determine the tumor grade and subtype.
Tumors are graded on a scale of 1 to 3, based on how abnormal the cells appear compared to normal cells. The higher the grade, the more aggressive the cancer, meaning that it tends to be growing quickly.
The subtype is important because treatment and outlook will vary depending on which subtype of breast cancer that you have. Subtypes include:
Interobserver And Intraobserver Agreement
For interobserver agreement, the ICC between two readers was calculated. The ICC was 0.77 for mean, 0.81 for SD, 0.82 for entropy, 0.80 for MPP, 0.28 for skewness, and 0.16 for kurtosis. For intraobserver agreement, the ICC for reader 1 was 0.98 for mean, 0.93 for SD, 0.98 for entropy, 0.99 for MPP, 0.32 for skewness, and 0.18 for kurtosis, and that for reader 2 was 0.95 for mean, 0.90 for SD, 0.91 for entropy, 0.95 for MPP, 0.30 for skewness, and 0.19 for kurtosis.
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What Are The Treatment Options For Stage 3 Breast Cancer
Another way a doctor may describe stage 3 breast cancer is if its operable or inoperable. This will determine further treatments.
If a cancer is operable, this means a doctor believes most or all of the cancer can be removed with surgery.
Inoperable cancer is still treatable with systemic therapy, but surgery isnt the right option because doctors feel they cant remove enough cancerous cells.
Treatment options for stage 3 breast cancer may include:
- Surgery: known as a mastectomy, to remove cancerous tissue and also to remove lymph nodes
- Hormone therapy: to slow or stop the growth of cancerous cells, if hormones are driving their growth
- Chemotherapy: involves taking medications to kill fast-growing cancer cells
- Targeted therapy: uses your genes to attack cancer cells without harming healthy cells
Your doctor may also recommend a combination of two or more treatments.
What Does Stage 3 Mean
Because stage 3 breast cancer has spread outside the breast, it can be harder to treat than earlier stage breast cancer, though that depends on a few factors.
With aggressive treatment, stage 3 breast cancer is curable however, the risk that the cancer will grow back after treatment is high.
Doctors further divide stage 3 cancer into the following stages:
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Ct Texture Analysis And Survival Outcomes
The CT textural features were compared between survivors and non-survivors . When no image filtration was used, non-survivors showed lower mean attenuation, SD, MPP, and entropy on CT images . However, textural features obtained using an SSF of 26 showed no differences between survivors and non-survivors . Receiver operating characteristic curve analyses determined that the optimal cutoff values were 66.79 HU for mean attenuation, 38.84 for SD, 67.54 for MPP, and 5.01 for entropy on CT images . Using these cutoffs, textural features were categorized into two groups. KaplanMeier curves were generated to compare OS between the two groups, and the log-rank test revealed that the textural features were significantly associated with OS outcomes . The KaplanMeier curve of M stage was shown in Supplementary Figure 2.
Table 2. Comparison of CT texture features between survivors and non-survivors.
Figure 4. KaplanMeier curves. There were significant differences in overall survival according to attenuation of 66.79 HU in mean on post-contrast the CT image , attenuation of 67.54 HU in MPP on the CT image , SD of 38.84 on the CT image , and 5.01 in entropy on the CT image . HU, Hounsfield units MPP, mean of positive pixels SD, standard deviation.
Heres What You Need To Know About Inflammatory Breast Cancer
Inflammatory breast cancer is a rare and aggressive form of the disease that doesnt get a lot of attention. Its tough to diagnose because of its unusual symptoms, and its more common in young women which makes it particularly tricky since the symptoms mimic that of mastitis, a common breast infection in new moms who breastfeed. Heres what you need to know:
The symptoms for IBC dont appear like regular breast cancers. First off, you dont often find a lump. Instead, your breast may appear red, itchy, swollen, warm and tender. This happens because of the way the cancer cells have formed in the breast. They block the lymph vessels in your skin causing infection-like symptoms instead of one solid lump.
When IBC is initially diagnosed it is always considered locally advanced. This is because it has already spread to surrounding tissue in the skin and/or lymph nodes. Further tests are done to confirm if it has spread beyond local tissue to distant organs, known as stage IV or metastatic. It can be a very aggressive, fast-growing cancer so treatment can also be aggressive.
From Cured To Stage 4
Others, like Teri Pollastro, a 54-year-old stage 4 patient from Seattle, respond surprisingly well.
Diagnosed with early stage ductal carcinoma in situ in 1999, Pollastro underwent a mastectomy but did not receive chemotherapy, radiation or tamoxifen, since her cancer was ER negative.
âThey used the C-word with me, they told me I was cured,â she said. âEvery time I went back to my oncologist, he would roll his eyes at me when I had questions.â
In 2003, Pollastro switched to Seattle Cancer Care Alliance where she saw Dr. Julie Gralow, a breast cancer oncologist and clinical researcher at Fred Hutchinson Cancer Research Center. Gralow discovered Pollastroâs cancer had metastasized to her liver.
âMy husband and I were in shock,â said Pollastro of her mets diagnosis. âYou donât go from being cured to stage 4.â
Pollastro went on Herceptin, a type of immunotherapy for women with HER2-positive metastatic breast cancer, and did six months of chemotherapy.
âI felt better right away with the treatment,â she said. âBut the problem is, it stopped . Thatâs what you can expect with mets. And thereâs always some residual cancer. And that starts percolating.â
And along with mets, she also had to deal with many misconceptions regarding her disease.
The Mercer Island, Washington, mother of two, who often counsels newly diagnosed patients, sometimes even found it difficult to relate to early stage breast cancer survivors.
When Should I Call My Doctor If I Am Concerned About Inflammatory Breast Cancer
Contact your healthcare provider immediately if you notice any changes to your breast, even if you dont feel a lump. With further testing, your provider can determine whether IBC may be a concern.
Contact your provider if youre taking antibiotics for a breast infection especially if you have the symptoms of IBC and your symptoms dont improve within a week.
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Analysis Of Bcss By Breast Cancer Moleculor Subtypes
The clinicopathological features of breast cancer with different molecular subtypes are depicted in Table . The 3-years BCSS was higher for patients with HR/HER2+ IBC than HR/HER2+T4-non-IBC patients , but lower for HR/HER2- IBC than HR/HER2- T4-non-IBC patients . In the rest of the tumor subtypes, BCSS did not differ significantly between IBC and T4-non-IBC patients .
Table 3 Patient Characteristics Stratified by Breast Cancer Moleculor SubtypeFig. 2
Breast cancer-specific survival for patients with IBC and T4-non-IBC stratified by breast cancer moleculor subtype. a HR+/HER2- HR+/HER2+ HR/HER2+ HR/HER2-. HER2 indicates human epidermal growth factor receptor 2 HR, hormone receptor IBC,Inflammatory breast cancer T4-non-IBC, T4 noninflammatory breast cancer
Furthermore, we constructed four Cox multivariate regression models to investigate the specific interaction effects of the cancer type with breast cancer subtypes . The models were adjusted for age, grade, hormone receptor status, tumor stage, HER-2 status, and surgery. After adjusting for these variables, we observed that the hazard of breast cancer-specific deaths was significantly reduced in HR/HER2+ IBC patients and significantly increased in HR/HER2- IBC patients as compared to T4-non-IBC patients.
Table 4 Cox Proportional Hazards Regression Model Analysis of Breast Cancer-Specific Survival by Breast Cancer Moleculor Subtype
Diagnostic Tests That Inform The Clinical Stage
Many methods are used to detect and stage cancer. Some of the common tests include:
Biopsy: The doctor uses a needle to extract breast tissue or fluid, which is then sent to a lab. There, various techniques are used to examine different attributes, such as hormone receptor or HER2 status.
Tumor markers: Rapidly dividing cancerous cells interrupt some of the normal mechanisms of cell growth. This causes the cell to overproduce certain molecules. Lab tests detect these compounds, known as tumor markers, in blood or tissue samples.
Imaging techniques: Several different scans are used to examine characteristics of your cancer. Below are some of the noninvasive imaging techniques you might encounter:
- MRI scans use magnets and radio waves to generate detailed pictures of your tissues.
- CT scans use X-rays to look at your organs. Nuclear scans trace the flow of an injected safe radioactive dye in your body.
- PET scans are similar to nuclear scans but specifically examine glucose consumption in the bodysince cancer cells use more glucose than normal cells.
- Ultrasound imaging uses sound waves to see inside your body.
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What Causes Inflammatory Breast Cancer
Most inflammatory breast cancer is considered invasive ductal carcinoma. Ductal carcinoma is cancer that forms from cells lining your milk ducts. An invasive ductal carcinoma is cancer that spreads beyond your milk ducts, invading healthy tissue. Researchers dont know what causes these cells to become malignant .
Inflammatory breast cancer develops when cancer cells block lymph vessels. Lymph vessels are hollow tubes in your lymphatic system that allow lymph fluid to drain out of your breast. The blockage causes your breast to become red, swollen and inflamed. In most cases of IBC, cancer cells spread outward from your lymph vessels. Cancer that has metastasized affects your other organs and is harder to treat.
Although Inflammatory Breast Cancer Is Rare Quick Diagnosis Is Key
Inflammatory breast cancer is rare. According to the ACS, IBC accounts for only 1 to 5 percent of all breast cancers. Because IBC often does not cause a lump, may not show up on a mammogram and can easily be mistaken for an infection, it can be very difficult to diagnose.
Be sure to contact your provider if you experience any of the following symptoms for more than a week:
- Rapid changes in the appearance of one breast
- Change in the size, shape or heaviness of one breast
- Swelling or heaviness in one breast
- Red, purple or pink discoloration or a bruised appearance in one breast
- Unusual warmth in one breast
- Dimpling similar to an orange peel on the skin of one breast
- Enlarged lymph nodes under the arm or near the collarbone
- Tenderness, pain or itchiness in one breast
- A retracted or inverted nipple
If you are experiencing any of these symptoms, it doesnt mean that you have IBC. Still, youll want to follow up with your provider to ensure that youre in good breast health.
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Susan G Komen Research Spotlight
Komen partnered with the Inflammatory Breast Cancer Research Foundation, the Milburn Foundation, patient advocates, doctors and researchers to review what is known about IBC and to propose new ways to improve diagnosis and treatment.
A new research tool using a scoring system was proposed as a way to better define IBC to increase diagnostic accuracy and help guide treatment. This research tool uses information from several sources, including a doctors exam of the breast, a pathologists exam of a sample of tumor tissue and imaging.
This research tool is not yet available and needs to be validated in future studies.
*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.
Is Inoperable Breast Cancer Still Treatable
Although stage 3C breast cancer is defined as either operable or inoperable, an inoperable diagnosis doesnt necessarily mean that it cant be treated.
The term inoperable may mean that all the cancer in the breast and surrounding tissue cant be removed through simple surgery. When breast cancer is removed, a rim of healthy tissue around the tumor, called a margin, is also removed.
For breast cancer to be successfully removed, there needs to be healthy tissue in all margins of the breast, from your clavicle down to a few inches below the breast mound.
It is possible for inoperable breast cancer to become operable following a treatment to shrink the cancer.
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Outlook For People With Stage 3 Breast Cancer
Its natural to want to know your outlook, but statistics dont tell the whole story. Your breast cancer type, overall health, and many more factors beyond your control may affect treatment outcomes.
Establishing open communication with your treatment team can help you best assess where you are in your cancer journey.
Support groups can be a great source of comfort as you navigate your diagnosis through your treatment and beyond. Your doctors office or hospital can offer some suggestions and resources in your area.
What Questions Should I Ask My Doctor
Ask your healthcare provider about what your cancer diagnosis means for your treatment options and likely outcomes. Questions to ask include:
- What stage is my breast cancer?
- Which specialists will be involved in my care?
- What treatment options would you recommend?
- What outcomes should I expect from treatment?
- What are potential side effects or complications related to treatment?
- Can you connect me with resources ?
A note from Cleveland Clinic
Inflammatory breast cancer is a rare type of cancerthat spreads quickly. Schedule an appointment with your healthcare provider immediately if you notice changes in your breasts, especially a change in one breast but not the other. The changes may be a sign of a less serious condition, like an infection. Still, IBC spreads fast. If your symptoms are a sign of inflammatory breast cancer, youll want to begin treatment as early as possible. Dont delay seeking care that can potentially improve your prognosis.
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What Are The First Signs Of Inflammatory Breast Cancer
Inflammatory breast cancer can be challenging to catch because it doesnt often cause a lump like more common forms of breast cancer. Instead, the first signs are related to inflammation in your affected breast. These symptoms make it easy to confuse IBC for a less serious condition, like an infection.
Tests For Inflammatory Breast Cancer
Doctors determine a diagnosis based not just on the breast’s appearance, but on the results further testing, which may include:
- A biopsy that removes a small sample of affected tissue in your breast to be examined in a lab
- Biopsy results that show whether you have the HER2 protein, which is present in about 20 percent of breast cancer cases
- The determination of hormone receptor status, or whether you have more hormone receptors than usual within the cancer cells
Knowing whether your cancer has any of these characteristics will help you and your care team make informed treatment decisions.
If the biopsy results in an inflammatory breast cancer diagnosis, your doctor will likely order a breast magnetic resonance imaging to detect how much of the breast tissue and lymph nodes are affected, and whether the other breast has been affected . You may have other tests performed, including positron emission tomography scan, computed tomography scan and bone scan, to also see whether the cancer has spread to any other parts of the body.
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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. Ask your doctor how these numbers may apply to you, as they are familiar with your situation.