What Is Inflammatory Breast Cancer?

Overview

Rare and highly aggressive, inflammatory breast cancer is characterized by cancer cells blocking lymphatic capillaries in the breast surface. Because the breast frequently appears swollen, red, or inflamed, this type of breast cancer is referred to as “inflammatory” breast cancer. One to five percent of breast cancer diagnoses in the US is for inflammatory breast cancer, which is highly uncommon. The majority of inflammatory breast cancers are invasive ductal carcinomas, meaning they begin as cells lining the breast’s milk channels before spreading outside of the ducts. Breast cancer that is  inflammatory advances quickly, frequently in weeks or months. Depending on whether the cancer cells have migrated solely to adjacent lymph nodes or other tissues, inflammatory breast cancer is either stage III or stage IV illness at the time of diagnosis.

The following are other characteristics of inflammatory breast cancer:

• Inflammatory breast cancer is typically detected earlier in life than other types of breast cancer.
• African American women are more likely than white women to have inflammatory breast cancer and are also diagnosed earlier.
• Since many inflammatory breast cancers lack hormone receptors, they cannot be treated with hormone therapies like tamoxifen, which halt the proliferation of cancer cells propelled by estrogen.
• Compared to women of  standard weight, obese women are more likely to develop inflammatory breast cancer.
• While inflammatory breast cancer can affect men, it often does so at an older age than women.¹

Causes of inflammatory breast cancer

Unknown factors may be responsible for inflammatory breast cancer. Despite its name, inflammation does not indeed induce inflammatory breast cancer. Instead, the word “inflammatory” describes how the breasts seem. Redness, swelling, and changes in skin texture are the most noticeable signs and symptoms of the condition. These signs and symptoms are very similar to those that typically go along with an infection, injury, or irritation that causes increased  blood flow and the accumulation of white blood cells in the body’s tissue (inflammation). However, these signs appear when inflammatory breast cancer is present because the cancer cells in the breast surface restrict the lymphatic arteries.

Even though the precise causes of inflammatory breast cancer are unknown, it is known that cancer can manifest itself in the following ways:

• An aberrant cell forms in a milk duct during the start of inflammatory breast cancer.
• The aberrant cell develops and divides very quickly due to DNA mutations.
• Cancer cells can pile up and clog the lymphatic drainage system in the breast skin, which causes fluid to accumulate inside the breast.
• The malignant cells can sometimes migrate throughout  the body to the lymph nodes, tissues, and organs.²

Signs and symptoms of inflammatory breast cancer

The first sign of inflammatory breast cancer:

Due to the fact that it doesn’t frequently develop a lump like other prevalent forms of breast cancer, inflammatory breast cancer can be challenging to detect. The early symptoms are associated with inflammation (redness, swelling, and discomfort) in the breast that is afflicted. It is simple to mistake IBC for a less severe ailment, like an infection, due to these symptoms.

In three to six weeks, IBC symptoms advance rapidly and may include:

• Red, pink, or purple patches of discoloration, a bruise, or a rash covering one-third of your breast
• Orange-peel-like dimpling, pitting, or thickening of your breast skin
• One breast may experience discomfort, swelling, itching, hardness, or tenderness
• Burning, warmth, weight, or expansion of one breast
• The Nipple that is inverted or receded (a nipple that points inward)
• Pain in the nipple
• Nipple discharge
• Swollen lymph nodes under your arm or close to your collarbone³

Management and treatment for inflammatory breast cancer

Diagnosis

To detect or identify breast cancer, doctors frequently employ additional testing. Women may be sent to a breast surgeon or specialist. This does not necessarily imply that she has cancer or that surgery is necessary. These medical professionals are skilled at identifying breast issues.

• Breast Ultrasound - A device that produces sonograms-pictures of regions inside the breast using sound waves.
• Diagnostic mammogram - Doctors may recommend  diagnostic mammography if you have a breast issue, such as lumps, or if a breast region seems abnormal on a screening mammogram. This particular X-ray of the breast is more in-depth.
• Breast magnetic resonance imaging (MRI) - A body scan technique that utilizes a magnet and a computer. Areas inside the breast will be captured in fine detail by the MRI scan.
• Biopsy - This test involves taking tissue or fluid from the breast to be examined under a microscope and put through additional testing. There are various types of biopsies (for example, Fine needle aspiration, core biopsy, or open biopsy).

Staging

If breast cancer is found, more tests are performed to determine whether cancer cells have spread within the breast or other body areas. This process is known as staging. Your breast cancer’s stage depends on stage whether the disease has progressed outside of the breast, lymph nodes beneath your arm, or both.⁴

Treatment

Your doctor determines your breast cancer treatment options based on your type of breast cancer, its stage and grade, size, and whether the cancer cells are sensitive to hormones. Your doctor also considers your overall health and your preferences.

Breast cancer surgery

• Removal of breast cancer (lumpectomy) - A lumpectomy, also known as breast-conserving surgery or wide local excision, involves the surgeon removing the tumor and a small margin of healthy tissue from the surrounding area.
• Removing the entire breast (mastectomy) - The entire breast tissue is removed during a mastectomy. All breast tissue, including the lobules, ducts, fatty tissue, and some skin, including the nipple and areola, are often removed during a mastectomy.
• Removing a limited number of lymph nodes (sentinel node biopsy) - Your surgeon will go through with you the importance of removing the lymph nodes that are the first to receive the lymph drainage from your tumor to identify whether cancer has spread to those nodes.
• Removing several lymph nodes (axillary lymph node dissection) - Your surgeon will review the pros and cons of removing additional lymph nodes from your armpit if cancer is discovered in the sentinel lymph nodes.
• Remove both breasts - If they have a very high chance of developing cancer in the other breast due to a genetic predisposition or a significant family history, some women with cancer in one breast may elect to have their second (healthy) breast removed (contralateral preventive mastectomy).

Radiation therapy

High-powered energy beams, such as X-rays and protons, are used in radiation therapy to kill cancer cells. Usually, a significant piece of equipment used for radiation therapy directs energy beams at your body (external beam radiation). But radioactive material can also be put inside your body to cause radiation (brachytherapy). 

Chemotherapy

Chemotherapy uses medication to kill rapidly proliferating cells, such as cancer cells. Your doctor may suggest chemotherapy following surgery if your cancer has a high risk of coming back or spreading to another area of your body to lessen the likelihood that it will come back. Women whose cancer has already spread to other body parts may undergo chemotherapy. To try to control cancer and lessen any symptoms it may be causing, chemotherapy may be advised.

Hormone therapy

Breast cancers that are hormone-sensitive are treated with hormone therapy, perhaps more accurately referred to as hormone-blocking therapy. These malignancies are referred to by doctors as ER-positive (estrogen receptor positive) and PR-positive (progesterone receptor positive) cancers. To reduce the likelihood of your cancer returning, hormone therapy can be administered either before or after surgery or other treatments. Hormone therapy may reduce and control cancer if it has already spread.

The following therapies can be applied in hormone therapy:

• Drugs that prevent hormones from clinging to cancer cells (selective estrogen receptor modulators).⁵
• Drugs that prevent the body from producing estrogen following menopause (aromatase inhibitors).
• Stopping the ovaries’ ability to produce hormones by surgery or medication.         

Targeted therapy drugs

Drug therapies that target particular abnormalities in cancer cells do so. For instance, some of the medications used in targeted therapy target human epidermal growth factor receptor², a protein that some breast cancer cells overproduce (HER2). The protein promotes the growth and survival of breast cancer cells. The medication can harm cancer while preserving healthy cells by concentrating on cells that produce excessive amounts of HER2.

Immunotherapy

Your immune system is used in immunotherapy to combat cancer. Because cancer cells create proteins that make immune system cells blind, your body’s immune system may fail to fight your cancer. Immunotherapy affects that process to work.

Supportive (palliative) care

Palliative care is a type of specialist medical treatment that relieves pain and other severe sickness symptoms. Specialists in palliative care collaborate with you, your loved ones, and other medical professionals to add an extra layer of support to your ongoing treatment. While receiving more invasive therapies like surgery, chemotherapy, or radiation therapy, palliative care is used.        

FAQs

How is inflammatory breast cancer diagnosed

Breast imaging, a breast core biopsy, and a skin punch biopsy are used to confirm an inflammatory breast cancer diagnosis. A small sample of  breast tissue or breast skin is removed by the doctor during a breast biopsy or skin punch biopsy, respectively.⁶

How can I prevent  inflammatory breast cancer

Inflammatory breast cancer cannot be prevented. Early therapy is vital for the best results. As soon as possible, inform your healthcare practitioner of any breast changes.

How common is inflammatory breast cancer

1-5% of breast cancer diagnoses in the US are for inflammatory breast cancer, which is highly uncommon. Most inflammatory breast cancers are invasive ductal carcinomas, meaning they begin as cells lining the breast milk channels before spreading outside of the ducts.

Who’s  at higher risk of inflammatory breast cancer

Since many inflammatory breast cancers lack hormone receptors, they cannot be treated with hormone therapies like tamoxifen, which healthy the proliferation of cancer cells propelled by estrogen. Obese women are more likely to develop inflammatory  breast cancer than women of normal weight.

When should I see a doctor

Even if you don't feel a lump, you should still get in touch with your healthcare practitioner immediately if you detect any changes in your breast. Your provider can determine whether IBC might be a problem with additional testing.

If you are taking antibiotics for  breast infection and your symptoms don’t go away after a week, talk to your doctor, especially if you have the sign of IBC.  

Summary

A rare form of cancer that spreads rapidly is inflammatory breast cancer (IBC). If you notice changes in your breast, particularly if one breast changes but not the other, make an appointment with your healthcare provider immediately. The alteration could indicate an infection or another less serious condition. However, IBC spreads quickly. You should start treatment right once if your symptoms indicate inflammatory breast cancer. Don’t delay seeking treatment, that might enhance your prognosis.