Understanding Inflammatory Breast Cancer Symptoms and Treatment

October 18, 2024 Fazi Jutt

Written by Dr. Syeda Jannat Shayyan for JiniNews

Inflammatory breast cancer (IBC) is a rare but aggressive form of breast cancer that accounts for 1-5% of all breast cancer cases. It differs from other types of breast cancer in its rapid onset and lack of a traditional lump, making it harder to detect and diagnose. Its aggressive nature requires early identification and prompt treatment to improve outcomes.

This comprehensive guide aims to raise awareness about IBC, discuss its symptoms, diagnosis, and explore available treatments. By shedding light on this particular type of breast cancer, we aim to help readers understand its impact and importance of timely medical intervention.

What is Inflammatory Breast Cancer (IBC)?

Inflammatory breast cancer is a rare subtype of breast cancer where cancer cells block lymphatic vessels in the skin of the breast, leading to an inflammatory appearance. Unlike typical breast cancer that forms a palpable lump, IBC often presents with redness, swelling, and thickened skin, mimicking an infection or rash. This makes it more challenging to identify without medical examination.

The name “inflammatory” refers to the red, swollen appearance of the breast rather than any infection. Due to its fast-moving nature, IBC is usually diagnosed at a later stage than other forms of breast cancer, making it a particularly dangerous type if not caught early.

Key Characteristics of IBC:

More aggressive and rapid growth than other types of breast cancer
Often affects younger women
Does not present with a typical lump
Causes noticeable changes in the skin and breast tissue

Symptoms of Inflammatory Breast Cancer

Identifying the symptoms of IBC is crucial because they differ significantly from more common forms of breast cancer. The absence of a lump can lead many women to dismiss the signs as minor or unrelated to cancer. Being aware of the symptoms can increase the chances of early diagnosis.

Common Symptoms of IBC:

Swelling and Redness: One of the primary signs of IBC is rapid swelling of the breast, often accompanied by redness that covers at least a third of the breast. The swelling may happen within a matter of weeks or even days.
Skin Changes: The skin of the breast may become thickened or dimpled, resembling an orange peel (a condition known as peau d’orange). This is caused by cancer cells blocking lymphatic vessels.
Warmth: The breast may feel warm to the touch, often misinterpreted as an infection.
Nipple Changes: The nipple may become flattened, inverted, or show signs of unusual discharge.
Pain and Tenderness: Unlike many forms of breast cancer that are painless, IBC can cause significant discomfort, pain, or tenderness in the breast.
Itching or Burning Sensation: Some women may experience itching or a burning feeling in the affected breast, further complicating the diagnosis as it may resemble a skin infection.

The Importance of Early Detection

Because of the rapid progression of IBC, early detection is critical to improving outcomes. If any of these symptoms appear and persist for more than a week, it’s essential to seek medical advice immediately. Many women may dismiss the early signs as an infection or skin irritation, but a delay in seeking treatment can lead to a more advanced stage of the disease.

How Inflammatory Breast Cancer is Diagnosed

Diagnosing IBC can be more complicated than diagnosing other forms of breast cancer. The absence of a palpable lump means that traditional mammograms may not detect the cancer. Additionally, the similarity of IBC symptoms to those of benign infections (such as mastitis) may delay diagnosis.

Diagnostic Procedures:

Physical Examination: A doctor will first conduct a thorough physical exam, paying close attention to skin changes, swelling, and other unusual symptoms in the breast.
Imaging Tests:
- Mammogram: Although not always effective in detecting IBC, mammograms are typically the first step in examining any unusual changes in the breast.
- Ultrasound: An ultrasound can help determine whether there is fluid build-up or other abnormalities that aren’t detected through a mammogram.
- MRI: A breast MRI can provide more detailed images, particularly when there are skin and tissue changes without a clear lump.
Biopsy: To confirm a diagnosis of IBC, a tissue sample must be taken from the affected area. A skin punch biopsy or a core needle biopsy can be used to collect cells for examination. Pathologists will check for cancer cells and determine if they are blocking lymphatic vessels.
Lymph Node Biopsy: In many cases, cancer cells spread to nearby lymph nodes. A biopsy of the lymph nodes can help in assessing the extent of cancer.

Stages of Inflammatory Breast Cancer

Inflammatory breast cancer is typically diagnosed at stage III or higher, given its aggressive nature. Staging helps determine the extent of cancer and guides the treatment approach.

Stage III: The cancer has spread to nearby tissues, including the skin and chest wall, but may not have reached distant organs.
Stage IV: The cancer has metastasized to other parts of the body, such as the liver, lungs, bones, or brain. This is the most advanced stage and is more challenging to treat.

Treatment Options for Inflammatory Breast Cancer

Given the aggressive nature of IBC, treatment is usually multi-modal, involving a combination of therapies designed to shrink the cancer, remove affected tissue, and prevent recurrence. Early and aggressive treatment is the key to improving outcomes.

1. Chemotherapy

Chemotherapy is often the first line of treatment for IBC. It is used to shrink the tumor and kill cancer cells before surgery. This approach, known as neoadjuvant chemotherapy, helps reduce the size of the tumor and increase the chances of a successful surgery. It may also help eliminate cancer cells that have spread to other areas of the body.

2. Surgery

After chemotherapy, surgery is typically performed to remove any remaining cancer. The most common surgical procedure for IBC is a mastectomy, which involves the removal of the entire breast, including the nipple and nearby lymph nodes. Since IBC affects the skin and tissue more broadly, a lumpectomy (removal of just the tumor) is usually not an option.

3. Radiation Therapy

Radiation therapy is often used after surgery to destroy any remaining cancer cells in the chest wall, skin, or lymph nodes. This helps reduce the risk of recurrence and improve long-term survival rates. Radiation is usually recommended for patients who have undergone a mastectomy, particularly if the cancer has spread to the skin or nearby tissues.

4. Targeted Therapy

For some patients, targeted therapy may be an effective treatment option. HER2-positive breast cancer, a subtype of IBC, can be treated with drugs like trastuzumab (Herceptin), which specifically targets HER2 receptors on cancer cells, blocking their growth and spread.

5. Hormone Therapy

If the cancer is hormone receptor-positive, hormone therapy may be used to block the body’s production of estrogen or prevent estrogen from stimulating the growth of cancer cells. Drugs like tamoxifen or aromatase inhibitors may be prescribed depending on the patient’s hormonal status.

6. Clinical Trials

Due to the rarity and aggressive nature of IBC, some patients may choose to participate in clinical trials that explore new treatments and therapies. These trials can offer access to cutting-edge treatments not yet available to the general public.

Prognosis and Survival Rates

The prognosis for IBC is often less favorable than for other forms of breast cancer, primarily due to its rapid progression and later-stage diagnosis. However, advances in treatment options are improving outcomes for many patients. The five-year survival rate for IBC is about 41%, but individual outcomes vary depending on the stage of diagnosis, response to treatment, and overall health.

Preventing and Reducing the Risk of IBC

While the exact cause of IBC is not fully understood, certain lifestyle changes may reduce the risk of developing breast cancer:

Maintain a Healthy Weight: Obesity has been linked to an increased risk of developing breast cancer, including IBC.
Regular Exercise: Physical activity can help lower cancer risk by maintaining hormone balance and reducing inflammation in the body.
Limit Alcohol Consumption: Studies have shown a correlation between alcohol use and an increased risk of breast cancer.
Routine Screenings: While IBC may not be detected through traditional mammograms, regular self-examinations and awareness of symptoms can aid in early detection.

Conclusion

Inflammatory breast cancer is a rare but aggressive form of breast cancer that demands early recognition and swift treatment. Understanding its unique symptoms, such as rapid swelling, redness, and skin changes, can help with early detection, which is vital for improving outcomes. With a combination of chemotherapy, surgery, radiation, and newer therapies like targeted treatments, the fight against IBC is progressing. If you or someone you know is experiencing symptoms of IBC, don’t wait—seek medical advice right away.

Understanding Inflammatory Breast Cancer Symptoms and Treatment