Ibc Signs And Symptoms
Typically, breast cancer symptoms develop slowly over time. With inflammatory breast cancer, however, symptoms progress quickly over days or weeks. Women often report receiving an inaccurate diagnosis of mastitis or breast infection because the symptoms are similar:
- Changed breast appearance, including darkened skin coloring, dimpling, ridges or thickening of the skin
- Flattened or inverted nipple
- Redness covering more than one-third of the breast
- Swelling of lymph nodes near the neck or under the arm
- Swelling that affects one breast, causing it to be larger than the other
- Warm or hot skin
If you experience these symptoms and receive an antibiotic treatment for infection, but your symptoms dont resolve within a week, its important to follow up with your provider.
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.
When To Seek Medical Attention
Pain, discomfort, and minor changes to the breasts arent always an indication of IBC. Sometimes, they can be due to another underlying condition.
However, since IBC is aggressive, early diagnosis and treatment are important. If you have any of the symptoms mentioned above or have noticed any abnormal changes to your breasts, consult with a doctor as soon as possible.
One of the most important ways to prepare for your appointment is by keeping track of symptoms youre concerned about. If possible, write down notes about:
- when the symptoms began
- how the symptoms feel
- anything else your doctor might need to know
After you and your doctor have reviewed your symptoms, they will likely perform a physical exam and review of your medical history to determine if there are other reasons for your symptoms.
Its likely that your doctor will also want to perform diagnostic testing, which may include:
If you have been diagnosed with IBC, treatment will begin right away and usually includes chemotherapy to reduce the size of the tumor, followed by surgery and radiation therapy.
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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.
Why Might These Symptoms Seem To Come And Go
IBC is a fast-growing, aggressive form of breast cancer. Unlike other types of breast cancer, symptoms of this condition are primarily caused by inflammation, which leads to swelling, pain, redness, and other symptoms.
When the symptoms of IBC appear, they may come and go in the beginning. In fact, some of the symptoms mentioned above can appear suddenly and may be mistaken for another condition with similar symptoms, such as an infection or rash.
However, unlike other conditions that resolve over time with treatment, the symptoms of IBC become worse over a period of weeks or months. Although they may vary in intensity, once the cancer has begun to spread, it will continue to cause pain, swelling, and other symptoms in the affected breast.
Unfortunately, inflammatory breast cancer symptoms will not resolve on their own without treatment or intervention, so its important to see a doctor immediately if you have any of the symptoms mentioned above.
There are a handful of other conditions can share symptoms with inflammatory breast cancer, including the following:
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Inflammatory Breast Cancer: How To Spot It And What To Do About It
Many things can cause skin changes on the breasts, and its normally no big deal. Rarely, it could signal a more serious condition called inflammatory breast cancer . Keep reading to learn about common causes of breast skin changes diagnosis and treatment for IBC what to watch out for and how to protect your health.
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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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.
All Inflammatory Breast Cancers Are Deemed To Be One Of Three Stages:
- Stage IIIB denotes that the IBC has spread locally to the skin, chest wall, or breast muscles.
- Stage IIIC denotes that a patient’s IBC has spread to the lymph nodes in the area surrounding your collarbone and possibly, to the lymph nodes under your arm or in your breast as well as into tissue near your breast.
- Stage IV denotes that cancer has spread to other parts of your body, usually to the lungs, liver, brain, and/or bones.
Your oncologist will determine your hormone-receptor status most IBC is hormone-receptor negative. They will also check your human epidermal growth factor receptor 2 status many inflammatory breast cancers are HER2 positive. These determinations help guide treatment decisions.
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Inflammatory Breast Cancer And Hormone Receptor Status
Inflammatory breast cancer tumors often have increasedangiogenesis and lymphangiogenesis.
Furthermore, IBC tumors also frequently show an overexpression of HER-2, RhoC GTPase, and NFB genes.
Inflammatory breast cancers are more likely to be negative for Estrogen receptor status and/or progesterone receptor status .
Inflammatory breast cancer tumors have a higher frequency of ER- and PR- tumors in comparison to other advanced breast cancer tumors. Indeed, some studies show that up to 83% of IBC tumors are ER-. This tends to affect the efficacy of treatment as the tumors do not respond to hormone therapy.
Data from the Surveillance, Epidemiology and End Results database show a higher median survival rate in inflammatory breast cancer ER+ tumors compared with ER- tumors .
Clinical Trials For Ibc
Research is ongoing to improve treatment for IBC.
New therapies are being studied in clinical trials. The results of these trials will decide whether these therapies will become part of the standard of care.
After discussing the benefits and risks with your health care provider, we encourage you to consider joining a clinical trial.
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Targeted Therapies And Hormone Therapy
Many inflammatory breast cancers are HER2 positive , so treatment with HER2-targeted therapies can be effective in controlling the tumor. These drugs are usually given along with the other treatments after a diagnosis of IBC. If the cancer is sensitive to estrogen, hormone therapy may also be an option.
Most inflammatory breast cancers are estrogen receptor and progesterone receptor negative, so hormonal therapy with tamoxifen or aromatase inhibitors isn’t commonly used.
Stage 4 Inflammatory Breast Cancer Treatment
Cancer thats spread to more distant areas of the body is typically treated using one or a combination of the systemic therapies mentioned above. These include:
Its unclear exactly what causes IBC to occur. In general, cancer develops due to genetic changes. These can happen due to a variety of factors, such as:
- genetic changes inherited from your parents
- errors that naturally occur during cell division
- damage to DNA through environmental exposures
Sometimes mutations can happen in genes that are associated with cell growth and division. When this happens, cells can begin to grow and divide out of control.
In IBC, cells in the breast ducts or lobules begin to rapidly grow and divide. As cancer cells build up, they block the lymph vessels in the skin of the breast. These leads to the redness, swelling, and dimpling associated with IBC.
There are a few risk factors associated with developing IBC. These include:
- Age. IBC typically occurs in younger women.
- Weight. People that have overweight or obesity are more likely to develop IBC.
- Race. Research shows that IBC occurs more frequently in Black women compared with white women.
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What Are The Signs And Symptoms Of Inflammatory Breast Cancer
The symptoms of inflammatory breast cancer can develop quite quickly. A lump may or may not be present. Symptoms can include:
- Redness, warmth or swelling of the breast
- The skin of the breast changing colour or looking bruised
- Dimpling, ridges or thickening of the skin. Or the breast looking pitted like the skin of an orange
- An increase in breast size
- Pain or tenderness in the breast
- Persistent itching of the breast
- An inverted nipple
- Swelling or lumps in the armpit or around the collar bone
How Is Ibc Treated
Treatment for IBC usually starts out with chemotherapy, followed by surgery and breast cancer radiation therapy.
- Recommendations for chemotherapy cycles average six cycles over a span of four to six months.
- Radiation therapy is generally given five days a week for five to six weeks.
The goal of chemotherapy for breast cancer is to shrink the tumor or tumors as much as possible before surgery so the oncologist can surgically remove as much cancer as possible. If your cancer is HER2-positive, you may also undergo a targeted therapy. If your hormone receptor status was positive, your provider may suggest hormone therapy.
A mastectomy is usually indicated for people with IBC, and if your provider finds cancer in the lymph nodes, these organs may be surgically removed as well. Many people with IBC have radiation therapy following surgery. Its possible to have breast reconstruction, but because radiation therapy is so important in IBC, its recommended to wait until after your radiation is finished.
Consider getting a second opinion or even several opinions to be sure youre comfortable with your surgical team and that youre getting the information you need to make a decision thats right for you.
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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.
Deterrence And Patient Education
Breast cancer is the most common female cancer in the United States and the second most common cause of cancer death in women. Early detection and treatment of breast cancer will improve survival. Self-breast examination and screening mammograms play a crucial role in the early diagnosis of breast cancer. Patient-centered assessment and intervention with specific regard to cultural beliefs and practices should be considered. The participation of individuals, along with the involvement of the community, health care professionals, and organizations, is strongly recommended in increasing the awareness of breast cancer and its treatments.
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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.
What Are The Early Signs And Symptoms Of Inflammatory Breast Cancer
Unlike more common types of breast cancer, this type generally doesnât show up as a lump. The disease grows as nests or sheets under the skin.
Symptoms of inflammatory breast cancer may include:
- Pain in the breast
- Skin changes in the breast area. You may find pink or reddened areas often with the texture and thickness of an orange.
- A bruise on the breast that doesn’t go away
- Sudden swelling of the breast
- Itching of the breast
- Swelling of the lymph nodes under the arm or in the neck
These changes often happen quickly, over a period of weeks.
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Inflammatory Breast Cancer Treatment
Inflammatory breast cancer is generally treated first with chemotherapy to help shrink the tumor, then with surgery to remove the tumor, followed by radiation therapy. This approach to treatment is called a multimodal approach. Studies have found that women with inflammatory breast cancer who are treated with a multimodal approach have better responses to therapy and longer survival.
This is an aggressive and fast-growing cancer. Women with this cancer dont tend to survive as long as women diagnosed with other types of breast cancer. Your doctors prediction of how well your treatment will work depends on the tumor size, whether the cancer has traveled to the lymph nodes and how well the cancer shrinks when chemotherapy is given. There are some very effective treatments for inflammatory breast cancer. Your doctor will work with you to find the treatment that is right for you.
If you or a loved one suspects triple-negative breast cancer, please call and speak to one of our Cancer AnswerLine& rade nurses: . They are experienced in oncology care, including helping patients and their families who have questions about cancer. They can also assist you in getting the appointment process started, if you decide to have your care at the U-M Rogel Cancer Center.
Diagnosing Inflammatory Breast Cancer
If you are being treated for swelling or redness of the breast and it doesnt seem to be getting better after taking antibiotics for a week, your healthcare provider may order imaging tests to check for IBC. These tests may include an ultrasound and the following:
- Mammogram This test will be done to check the thickness of the skin and the density of the treated breast in comparison to the healthy breast.
- MRI It takes images of the breast and structures of your body using radio waves and magnets.
- CT This scan provides detailed images of your bodys insides.
- PET This scan, along with a CT, can find cancer in any area of the body, including the lymph nodes.
- Biopsy This test is done by removing a small piece of the skin or tissue of the breast to help diagnose cancer. A biopsy can sometimes be done with a needle or a surgical incision may be needed to remove tissue for testing. The type of biopsy performed with depends on whether a mass is discernible on imaging tests. The test will look for unusual cell growth and check for the presence of proteins found in some cancers.
Stages of Inflammatory Breast Cancer
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