Skin Rash On The Breasts
You may not associate breast cancer with redness or a skin rash, but in the case of inflammatory breast cancer , a rash is an early symptom. This is an aggressive form of breast cancer that affects the skin and lymph vessels of the breast.
Unlike other types of breast cancer, IBC doesnt usually cause lumps. However, your breasts may become swollen, warm, and appear red. The rash may resemble clusters of insect bites, and its not unusual to have itchiness.
Signs Of Breast Cancer Include A Lump Or Change In The Breast
These and other may be caused by breast cancer or by other . Check with your doctor if you have any of the following:
- A lump or thickening in or near the breast or in the underarm area.
- A change in the size or shape of the breast.
- A dimple or puckering in the skin of the breast.
- A turned inward into the breast.
- Fluid, other than breast milk, from the nipple, especially if it’s bloody.
- Scaly, red, or swollen skin on the breast, nipple, or .
- Dimples in the breast that look like the skin of an orange, called .
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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How Is Inflammatory Breast Cancer Treated
Inflammatory breast cancer treatments use a combination of chemotherapy, surgery and radiation.
- Chemotherapy: Chemotherapy for breast cancer uses drugs to kill cancer cells. You may receive chemo intravenously or as a pill. Chemotherapy shrinks cancer cells so theyre easier to remove during surgery. You may also receive chemotherapy after surgery to destroy any cancer cells that may remain after surgery.
- Surgery: Surgery removes your entire affected breast and nearby lymph nodes. More conservative treatments that remove tissue while sparing your breast arent effective with IBC. The cancer spreads too quickly.
- Radiation therapy:Radiation therapy uses a machine to direct energy toward the cancer, destroying the cancer cells. After surgery, you may receive radiation to kill any remaining cancer cells that surgery may have missed.
Depending on the characteristics of your cancer cells , you may receive treatments like targeted therapy, hormone therapy or immunotherapy.
Your healthcare provider may also recommend that you take part in a clinical trial. A clinical trial is a study that tests the safety and effectiveness of new cancer treatments. Treatments that are successful in clinical trials often become the standard treatment approaches.
Treating Inflammatory Breast Cancer
Inflammatory breast cancer that has not spread outside the breast is stage III. In most cases, treatment is chemotherapy first to try to shrink the tumor, followed by surgery to remove the cancer. Radiation and often other treatments, like more chemotherapy or targeted drug therapy, are given after surgery. Because IBC is so aggressive, breast conserving surgery and sentinel lymph node biopsy are typically not part of the treatment.
IBC that has spread to other parts of the body may be treated with chemotherapy, hormone therapy, and/or targeted drugs.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
American Joint Committee on Cancer. Breast. In: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer 2017:589.
Curigliano G. Inflammatory breast cancer and chest wall disease: The oncologist perspective. Eur J Surg Oncol. 2018 Aug 44:1142-1147.
Hennessy BT, Gonzalez-Angulo AM, Hortobagyi GN, et al. Disease-free and overall survival after pathologic complete disease remission of cytologically proven inflammatory breast carcinoma axillary lymph node metastases after primary systemic chemotherapy. Cancer. 2006 106:10001006.
National Cancer Institute. Inflammatory Breast Cancer. 2016. Accessed at https://www.cancer.gov/types/breast/ibc-fact-sheet on August 30, 2021.
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Skin Like An Orange Peel
Peau d’orange, or skin that looks and feels like an orange peel, is the most recognizable symptom of IBC. It involves dimpling and thickening of the breast skin, per the ACS. About 46% of people with IBC may experience dimpling or discoloration, per the September 2018 study.
This and other breast skin appearance changes occur because IBC cells block lymph vessels in the skin, causing lymphatic fluid to accumulate, per the NCI. The lymph vessels normally carry the lymph, part of the immune system, throughout the body to clear infection, per MedlinePlus.
Peau d’orange may be a symptom of other breast conditions, such as fibrocystic breast disease the most common non-cancerous breast disease, according to StatPearls. FBD also comes with pain and nipple discharge. It may affect anywhere between 3060% of women, most commonly between the ages of 3050.
Symptoms Of Angiosarcoma Of The Breast
Another rare form of breast cancer, angiosarcoma forms inside the lymph and blood vessels. Only a biopsy may definitively diagnose this type of cancer. Angiosarcoma can cause changes to the skin of your breast, such as the development of purple-colored nodules that resemble a bruise. These nodules, if bumped or scratched, may bleed. Over time, these discolored areas may expand, making your skin appear swollen in that area. You may or may not have breast lumps with angiosarcoma. If you also have lymphedema, which is swelling caused by a buildup of lymphatic fluid, angiosarcoma may occur in the affected arm. Cancer treatment sometimes damages the lymph vessels, which may lead to lymphedema.
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Breast Cancer Is A Disease In Which Malignant Cellsform In The Tissues Of The Breast
The is made up of and . Each breast has 15 to 20 sections calledlobes. Each lobe has many smaller sections called . Lobules end in dozens of tiny bulbs thatcan make milk. The lobes, lobules, and bulbs are linked by thin tubes calledducts.
Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also shown.
Each breast also has and . The lymph vessels carry an almost colorless called . Lymphvessels carry lymph between . Lymph nodes are small bean-shaped structures that arefound throughout the body. They filter substances in lymph and help fight and disease. Clusters of lymph nodes are found near the breast in the , above the, and in the chest.
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.
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Signs And Symptoms Of Inflammatory Breast Cancer
Inflammatory breast cancer causes a number of signs and symptoms, most of which develop quickly , including:
- Swelling of the skin of the breast
- Redness involving more than one-third of the breast
- Pitting or thickening of the skin of the breast so that it may look and feel like an orange peel
- A retracted or inverted nipple
- One breast looking larger than the other because of swelling
- One breast feeling warmer and heavier than the other
- A breast that may be tender, painful or itchy
- Swelling of the lymph nodes under the arms or near the collarbone
If you have any of these symptoms, it does not mean that you have IBC, but you should see a doctor right away. Tenderness, redness, warmth, and itching are also common symptoms of a breast infection or inflammation, such as mastitis if youre pregnant or breastfeeding. Because these problems are much more common than IBC, your doctor might suspect infection at first as a cause and treat you with antibiotics.
Treatment with antibiotics may be a good first step, but if your symptoms dont get better in 7 to 10 days, more tests need to be done to look for cancer. Let your doctor know if it doesn’t help, especially if the symptoms get worse or the affected area gets larger. The possibility of IBC should be considered more strongly if you have these symptoms and are not pregnant or breastfeeding, or have been through menopause. Ask to see a specialist if youre concerned.
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.
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Differential Diagnosis And Work
Other issues to consider are those that delay the diagnosis at presentation before a malignancy is identified. The differential diagnosis in a patient with signs or symptoms of inflammation of the breast without a diagnosis, i.e., those with inflammatory breast or inflammatory breast syndrome, includes both lactation-related and non-puerperal causes, and very few reports have been published that define the incidence of malignancy among patients presenting with inflammatory breast symptoms aside from lactation-related mastitis . This means that little literature is available to assist the generalist faced with a patient with an inflammatory breast to optimize the work-up and to distinguish malignant from non-malignant etiologies. The most common diagnosis causing inflammatory breast syndrome is infectious mastitis, which is most common during lactation and typically responds quickly to antibiotics. The crucial diagnosis to rule out is IBC, as IBC is always stage III at diagnosis and progresses rapidly to stage IV breast cancer when the diagnosis is delayed . Also important to recognize is that IBC can occur in pregnant and lactating women, making the diagnosis in such patients especially challenging.
Figure 2
There Are Three Ways That Cancer Spreads In The Body
Cancer can spread through , the , and the :
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the to other parts of the body.
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Keeping Personal Health Records
You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed.
This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their primary care doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.
If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan with them and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.
The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.
The word survivorship means different things to different people. Common definitions include:
A New Perspective On Your Health
For many people, survivorship serves as a strong motivator to make lifestyle changes.
People recovering from inflammatory breast cancer are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, exercising regularly, and managing stress. Regular physical activity can help rebuild your strength and energy level. Maintaining a healthy weight may also help lower the risk of a breast cancer recurrence and other medical conditions such as diabetes and heart disease. Your health care team can help you create an appropriate exercise plan based on your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.
To take care of your health, it is important to have recommended medical checkups and tests and to follow up with your primary health care provider.
Talk with your health care team to develop a survivorship care plan that is best for your needs.
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Inflammatory Breast Cancer Pictures
Accounting for one to five percent of all breast cancer cases in the United States, inflammatory breast cancer, or IBC, is an aggressive, rare form of this disease. Inflammatory breast cancer pictures show a red and/or swollen breast that appears inflamed. Most cases are invasive ductal carcinomas, which develop in the cells lining the milk ducts and spread throughout the breast. Cells also blocks the lymph vessels located in the skin of the breast.
What Is Peau Dorange
Thickened, firm, bumpy, and pitted skin can appear on the breast due to a variety of underlying conditions. Its sometimes called pseudo-cellulitis because it can appear similar to cellulitis. When we say cellulitis, were not talking about the bumpy appearance of fat that can accumulate in the butt and thighs. Thats called cellulite. Were talking about an infection in the skin that can appear red, bumpy, or uneven.
In the case of peau dorange, the affected breast might feel tender or develop sores or a scaly rash. Peau dorange isnt a disease by itself. That said, it may be a sign of an underlying medical condition and should prompt a visit with your healthcare provider. Thats because it can be caused by an infection or inflammation, which often requires further evaluation.
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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.
Correspondence to:
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.
Looking For More Survivorship Resources
For more information about cancer survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net:
- ASCO Answers Cancer Survivorship Guide: Get this 48-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The free booklet is available as a PDF, so it is easy to print.
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Cancer.Net Patient Education Video: View a short video led by an ASCO expert that provides information about what comes after finishing treatment.
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Survivorship Resources: Cancer.Net offers information and resources to help survivors cope, including specific sections for children, teens and young adults, and people over age 65. There is also a main section on survivorship for people of all ages.
The next section offers Questions to Ask the Health Care Team to help start conversations with your cancer care team. Use the menu to choose a different section to read in this guide.
This is the end of Cancer.Nets Guide to Inflammatory Breast Cancer. Use the menu to choose a different section to read in this guide.
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