Inflammatory breast cancer

 

Inflammatory breast cancer is a rare (one to five percent of all breast cancers), but aggressive disorder seen in women of any age. The symptoms are similar to that of inflammation and thus the name inflammatory breast cancer. This condition develops rapidly and is considered to be a locally advanced cancer, as the disease spreads from breast to the nearby lymph nodes.

Symptoms

Inflammatory breast cancer is characterized by red, tender, warm, and swollen breast.

  • Skin of the breast appears to be pink, reddish, or bruised
  • Enlargement of breast
  • Tenderness
  • Enlargement of lymph nodes
  • Flattening or inversion of nipple
  • Pitted skin

If you notice any of the above symptoms or if the symptoms persist even after treating breast disorders, consult your doctor immediately. Diagnosis is required to rule out other conditions such as breast injury or breast infection both of which have similar symptoms.

Causes

Causes of inflammatory breast cancer are not clear. However, cancers occur due to mutations in the DNA leading to abnormal cell division. These abnormal cells accumulate and block the lymphatic vessels making the skin red and swollen.

Risk factors

Inflammatory breast cancer can occur in people of any age group. However, the incidence is little higher in older adults. The condition is more common in women than men. Black women are more at risk than white women. Obesity also increases the risk of developing inflammatory breast cancer.

Diagnosis

Often, it is difficult to diagnose inflammatory breast cancer as the lump can’t be observed during a physical exam or through a mammogram as the breast tissue becomes dense. Your doctor begins the diagnosis with a physical examination. Other tests include:

  • Imaging tests – Your doctor advices a breast X-ray or mammogram and ultrasound scan to identify signs of cancer.
  • Biopsy – A full thickness skin biopsy is recommended to confirm the diagnosis.

Staging: Computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), or bone scans are performed for staging cancer. The stages of inflammatory breast cancer include:

Stage I: The tumor is small and has not spread to the other parts from the breast tissue.

Stage II: The tumor is small and has spread to the axillary lymph nodes

Stage III: In this stage, one-third of the breast tissue is affected with cancer and the disease has metastasized (spread) to nearby lymph nodes and fibrous connective tissue in the breast.

Stage IV: In this stage, cancer has spread to other parts of the body such as bones, lungs, or liver through a process called metastasis.

Treatment

The treatment for inflammatory breast cancer includes a multimodal approach that includes systemic therapy, surgery, and radiation therapy.

Systemic therapy is given to reduce the size of the tumor followed by surgery. Systemic therapy includes chemotherapy, targeted therapy, or hormone therapy. Surgery includes radical mastectomy, segmentectomy, or lumpectomy. All these procedures remove the affected breast tissue depending on the site affected. After surgery, your doctor recommends radiation therapy to kill the cancer cells present, if any.

Immediate reconstruction of breasts is not recommended after the surgery. Discuss your expectations with the doctor and choose the treatment.

The clinical outcomes (prognosis) of the treatment depend on the age, stage and location of cancer, and physical condition. As the disease is very aggressive, poor prognosis is seen with this condition. But with early diagnosis and prompt treatment, chances of survival can improve.

Coping and support

The treatment can be debilitating due to change in the shape of your breasts, which may be of aesthetic concern. To cope with the treatment and troublesome side effects, learn about the disease and involve in the treatment decisions, and seek support from friends and family members. You may also consult a counselor to keep yourself emotionally strong to survive with cancer.