Inflammatory Breast Cancer

Inflammatory Breast Cancer

Inflammatory breast cancer usually starts with a feeling of thickness or heaviness in the breast rather than with a lump.
 

Inflammatory breast cancer usually starts with a feeling of thickness or heaviness in the breast rather than with a lump. Considered rare, inflammatory breast cancer is an aggressive type of invasive breast cancer with symptoms and treatments that are different from other types of breast cancer.

Symptoms of inflammatory breast cancer include:

  • thickness, heaviness, or visible swelling of the affected breast

  • discoloration that makes the affected breast look red, pink, or even bruised

  • dimpling, pitting, or ridges on the skin of the affected breast, so it looks and feels like an orange peel

  • other breast skin changes, including welts or hives

  • flattening or inversion of the nipple

  • unusual warmth of the affected breast

  • tenderness, pain, aching, burning, or itchiness of the affected breast

  • enlarged lymph nodes under the arm or above the collarbone

Most of the symptoms of inflammatory breast cancer develop quickly — within three to six months. About 1% to 5% of all breast cancers are inflammatory breast cancers.

Inflammatory breast cancer is more common in:

  • women younger than 40

  • Black women

  • women who are overweight

A breast infection, such as mastitis if you’re pregnant or breastfeeding, can cause some of the same symptoms as inflammatory breast cancer. If you’ve been diagnosed with a breast infection that isn’t responding to treatment, you may want to consider asking your doctor about testing for inflammatory breast cancer.

 

Diagnosing inflammatory breast cancer

It can be difficult to diagnose inflammatory breast cancer because there is usually no lump to feel during a physical exam or to see in a mammogram. Doctors have to examine any changes to the breast and order a biopsy if they suspect inflammatory breast cancer.

Doctors also may recommend additional imaging tests, such as an ultrasound or breast MRI.

 

Staging inflammatory breast cancer

By the time a doctor diagnoses inflammatory breast cancer, the breast cancer cells have usually grown into the skin. This local advancement means the cancer is at least stage III. In some cases, the breast cancer cells have already spread to parts of the body away from the breast — which means the cancer is metastatic or stage IV.

After diagnosing inflammatory breast cancer, doctors order more tests to collect information about the cancer’s characteristics. These tests, as well as the results of your biopsy and any imaging tests, make up the various parts of your pathology report.

Doctors also collect the following information on inflammatory breast cancer:

  • lymph node status

  • hormone receptor status

  • HER2 status

 

Treating inflammatory breast cancer

Doctors offer treatments for inflammatory breast cancer in a different order from treatments for other types of breast cancer because the cancer is aggressive and has grown into the breast skin.

Doctors typically recommend:

  • chemotherapy to shrink the cancer and ease the swelling, which makes it easier for the surgeon to remove the cancer

  • targeted therapy at the same time as chemotherapy if the cancer is HER2-positive

  • mastectomy and lymph node removal if the cancer responded positively to treatment, meaning the breast skin shows little to no signs of inflammatory breast cancer symptoms

  • a different chemotherapy regimen or radiation therapy if the cancer has not responded well to treatment, meaning the breast skin is still showing signs of inflammatory breast cancer symptoms

After mastectomy, doctors recommend radiation therapy to destroy any remaining cancer cells. Still, in some cases, doctors may recommend more chemotherapy after mastectomy but before radiation therapy. Doctors do not offer radiation therapy after surgery to anyone who has radiation therapy before surgery because the cancer did not respond to chemotherapy.

Doctors also recommend:

  • hormonal therapy after you complete all chemotherapy if the cancer is hormone receptor-positive

  • additional targeted therapy treatment after you complete radiation therapy if the cancer is HER2-positive

 

Survivorship care after inflammatory breast cancer treatment

Treatments for inflammatory breast cancer (and other types of breast cancer) can increase many people’s risk of developing certain diseases and conditions as they get older, including high blood pressure, heart disease, or osteoporosis.

As a result, medical experts recommend survivorship care plans to help make sure people get regular screenings for these and other diseases and conditions.

Survivorship care plans are written documents made up of two parts. The first part is a treatment summary of all the breast cancer treatments you’ve received. The second part is a roadmap of what you can expect in the years after treatment, including any late or long-term side effects that you may have, and a schedule of how your healthcare team plans to make sure you get the screenings you need. This part of the survivorship care plan usually includes:

  • a list of tests you can expect to have

  • the doctors who plan to order each of the tests

  • a schedule of when you need to have each test

  • healthy living recommendations

  • any additional resources you may need, such as guidelines for making healthy lifestyle choices

Learn more about Planning Ahead for Survivorship.

Reviewed by 1 medical adviser
 
Jenni Sheng, MD
Johns Hopkins University School of Medicine, Baltimore, MD
Learn more about our advisory board

— Last updated on August 18, 2022, 3:54 PM

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