Inflammatory Breast Cancer

What Is Inflammatory Breast Cancer (IBC)?

Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer  that often appears as a rash or an irritated area of skin. It blocks the lymph vessels in the skin of your breast

Inflammatory breast cancer may not show up on a mammogram or ultrasound and is often misdiagnosed as an infection. By the time it’s diagnosed, it usually has grown into the skin of your breast. Often, it has already spread to other parts of the body, too.

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 doesn’t 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 (your doctor may call this locally advanced, meaning it’s moved into nearby skin) when it’s diagnosed
  • Has often spread past the breast (your doctor will say it has metastasized) when it’s diagnosed, which makes it harder to treat

What Are the Early Signs and Symptoms of Inflammatory Breast Cancer?

Unlike more common types of breast cancer, this type generally doesn’t 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
  • Nipple changes or discharge
  • Swelling of the lymph nodes under the arm or in the neck

These changes often happen quickly, over a period of weeks.

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.

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How Is Inflammatory Breast Cancer Diagnosed?

If you have swelling or redness on your breast that doesn’t go away and doesn’t get better with antibiotics after a week, your doctor may suspect inflammatory breast cancer. An ultrasound and other imaging tests will give a more detailed look at your breast.

Your doctor may order one or more of the following:

  • Mammogram. This can show if the affected breast is denser or if the skin is thicker than the other breast.
  • MRI . It uses powerful magnets and radio waves to make pictures of the breast and structures inside your body.
  • CT scan . It's a powerful X-ray that makes detailed pictures inside your body.
  • PET scan . Used together with a CT scan, this test can help find cancer in lymph nodes and other areas of the body.
  • Breast ultrasound. This imaging test uses sound waves to create a picture of the inside of your breast. It can help spot changes that don’t show up on mammograms.

A biopsy can tell for sure if you have cancer. A doctor will remove a small section of breast tissue or skin to test it.

Often, the sample can be taken with a needle, but sometimes a cut is made to remove it. The type of biopsy you have may depend on whether a mass can be seen on imaging tests.

The medical team will use what’s collected in the biopsy to look for any abnormal cell growth and also test for proteins associated with some cancers. If you’re diagnosed with inflammatory breast cancer, more tests can show how much of the breast and the area around it is affected.

How Is Inflammatory Breast Cancer Treated?

Because this form of cancer spreads quickly, you’ll need an aggressive treatment plan. It may include:

  • Chemotherapy This drug treatment is given before surgery to shrink the tumor and make the cancer operable. It also lowers the chance the cancer will come back.
  • Surgery. A mastectomy may be performed after chemotherapy. This procedure removes all of your breast.
  • Targeted therapy. If the cancer cells have too much of a protein called HER2, you may be given drugs specifically for that.
  • Hormone therapy. Certain medications may be given if the cancer cells have hormone receptors. These medicines block the receptors so they can’t attach to the hormones.
  • Radiation . Often, radiation treatments are given after chemotherapy and surgery to lower the chance of the cancer coming back.
  • Immunotherapy. These drugs use your immune system to help fight cancer. You might get them for advanced types of inflammatory breast cancer.

Talk to your doctor about clinical trials. Clinical trials test new drugs to see if they are safe and if they work. They’re often a way for people to try new medicine that isn't available to everyone. Your doctor can help find a trial that might be a good fit for you.

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What’s the Outlook for Inflammatory Breast Cancer?

This type of cancer is aggressive and is likely to have spread by the time it’s discovered. It’s 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 Institute’s Surveillance, Epidemiology, and End Results (SEER) database, survival rates for inflammatory breast cancer by stage at diagnosis are:

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

It’s 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.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on March 17, 2019

Sources

SOURCES:

National Breast Cancer Foundation:Inflammatory Breast Cancer (IBC).”

National Cancer Institute: “Inflammatory Breast Cancer.”

American Cancer Society: “Inflammatory Breast Cancer.”

Johns Hopkins Medicine: “Breast Ultrasound.”

News release, FDA.

National Cancer Institute: "Inflammatory Breast Cancer."

American Cancer Society: “Inflammatory Breast Cancer.”

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