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Definition

What is inflammatory breast cancer?

Inflammatory breast cancer occurs when cancer cells block the lymphatic vessels in skin covering the breast, causing the characteristic red, swollen appearance of the breast.

Inflammatory breast cancer is considered a locally advanced cancer — meaning it has spread from its point of origin to nearby tissue and possibly to nearby lymph nodes.

Inflammatory breast cancer can easily be confused with a breast infection, which is a much more common cause of breast redness and swelling. Seek medical attention promptly if you notice skin changes on your breast.

How common is inflammatory breast cancer?

Inflammatory breast cancer is rare, accounting for 1 to 5 percent of all breast cancers diagnosed in the United States. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of inflammatory breast cancer?

The common symptoms of inflammatory breast cancer are:

  • Rapid change in the appearance of one breast, over the course of several weeks
  • Thickness, heaviness or visible enlargement of one breast
  • Discoloration, giving the breast a red, purple, pink or bruised appearance
  • Unusual warmth of the affected breast
  • Dimpling or ridges on the skin of the affected breast, similar to an orange peel
  • Tenderness, pain or aching
  • Enlarged lymph nodes under the arm, above the collarbone or below the collarbone
  • Flattening or turning inward of the nipple

Inflammatory breast cancer doesn’t commonly form a lump, as occurs with other forms of breast cancer.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes inflammatory breast cancer?

It’s not clear what causes inflammatory breast cancer.

Doctors know that inflammatory breast cancer begins with an abnormal cell in one of the breast’s ducts. Mutations within the abnormal cell’s DNA instruct it to grow and divide rapidly. The accumulating abnormal cells infiltrate and clog the lymphatic vessels in the skin of your breast. The blockage in the lymphatic vessels causes red, swollen and dimpled skin — a classic sign of inflammatory breast cancer.

Risk factors

What increases my risk for inflammatory breast cancer?

There are many risk factors for inflammatory breast cancer, such as:

  • Being a woman. Women are more likely to be diagnosed with inflammatory breast cancer than are men — but men can develop inflammatory breast cancer, too.
  • Being black. Black women have a higher risk of inflammatory breast cancer than do white women.
  • Being obese. People who are obese have a greater risk of inflammatory breast cancer compared with those of normal weight.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

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 (redness), edema (swelling), and a peau d’orange appearance (ridged or pitted skin) 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.

Further examination of tissue from the affected breast should include testing to see if the cancer cells have hormone receptors (estrogen and progesterone receptors) or if they have greater than normal amounts of the HER2 gene and/or the HER2 protein (HER2-positive breast cancer).

Imaging and staging tests include the following:

  • A diagnostic mammogram and an ultrasound of the breast and regional (nearby) lymph nodes
  • A PET scan or a CT scan and a bone scan to see if the cancer has spread to other parts of the body

Proper diagnosis and staging of inflammatory breast cancer helps doctors develop the best treatment plan and estimate the likely outcome of the disease. Patients diagnosed with inflammatory breast cancer may want to consult a doctor who specializes in this disease.

How is inflammatory breast cancer treated?

Inflammatory breast cancer is generally treated first with systemic 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. Treatments used in a multimodal approach may include those described below.

  • Neoadjuvant chemotherapy: This type of chemotherapy is given before surgery and usually includes both anthracycline and taxane drugs. Doctors generally recommend that at least six cycles of neoadjuvant chemotherapy be given over the course of 4 to 6 months before the tumor is removed, unless the disease continues to progress during this time and doctors decide that surgery should not be delayed.
  • Targeted therapy: Inflammatory breast cancers often produce greater than normal amounts of the HER2 protein, which means that drugs such as trastuzumab (Herceptin) that target this protein may be used to treat them. Anti-HER2 therapy can be given both as part of neoadjuvant therapy and after surgery (adjuvant therapy).
  • Hormone therapy: If the cells of a woman’s inflammatory breast cancer contain hormone receptors, hormone therapy is another treatment option. Drugs such as tamoxifen, which prevent estrogen from binding to its receptor, and aromatase inhibitors such as letrozole, which block the body’s ability to make estrogen, can cause estrogen-dependent cancer cells to stop growing and die.
  • Surgery: The standard surgery for inflammatory breast cancer is a modified radical mastectomy. This surgery involves removal of the entire affected breast and most or all of the lymph nodes under the adjacent arm. Often, the lining over the underlying chest muscles is also removed, but the chest muscles are preserved. Sometimes, however, the smaller chest muscle (pectoralis minor) may be removed, too.
  • Radiation therapy: Post-mastectomy radiation therapy to the chest wall under the breast that was removed is a standard part of multimodal therapy for inflammatory breast cancer. If a woman received trastuzumab before surgery, she may continue to receive it during postoperative radiation therapy. Breast reconstruction can be performed in women with inflammatory breast cancer, but, due to the importance of radiation therapy in treating this disease, experts generally recommend delayed reconstruction.
  • Adjuvant therapy: Adjuvant systemic therapy may be given after surgery to reduce the chance of cancer recurrence. This therapy may include additional chemotherapy, hormone therapy, targeted therapy (such as trastuzumab), or some combination of these treatments.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage inflammatory breast cancer?

The following lifestyles and home remedies might help you cope with inflammatory breast cancer:

  • Learn enough about inflammatory breast cancer to make treatment decisions. Ask your doctor for the facts about your cancer and treatment. Ask what stage your cancer is and what treatment options you have. Also ask your doctor about good sources of information where you can learn more. Examples of organizations for reliable cancer information include the National Cancer Institute and the American Cancer Society.
  • Seek support. It might comfort you to talk about your feelings as you begin cancer treatment. You might have a close friend or family member who is a good listener. Or ask your doctor to refer you to a counselor who works with cancer survivors.
  • Connect with other cancer survivors. Other people with cancer can provide a unique source of support. Cancer survivors can offer practical advice on what to expect and how to cope during your treatment. Ask your doctor about support groups in your community.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: September 14, 2017 | Last Modified: September 14, 2017

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