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IBC - Inflammatory Breast Cancer

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Updated May 16, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Inflammatory Breast Cancer (IBC): Rare and Aggressive:

Inflammatory breast cancer is a rare and aggressive breast cancer that can cause the breast to appear red and swollen, giving the appearance of inflammation. In the United States, diagnoses of IBC account for one to 5 percent of all cases of breast cancer. Compared to other forms of breast cancer, inflammatory breast cancer tends to strike younger women. When IBC is diagnosed, it is found in young African Americans more often than in Caucasians. Men who are diagnosed with IBC are older on average than female patients. IBC is often mistaken for other conditions.

IBC Signs and Symptoms:

Cases of IBC will vary, but there are some common symptoms. You may not have all of these changes, you may not have a lump and IBC may not show up on a mammogram. Some symptoms can signal other conditions, so see your doctor for help.

  • Sudden increase in breast size (as much as a cup size in a few days)
  • Change in breast skin color: pink, red, or dark-colored areas
  • Skin looks like an orange peel (called peau d'orange)
  • Constantly itching breast skin
  • Breast is warmer, harder or firmer than usual
  • Breast pain not related to menstrual cycle
  • Nipple retraction - pulling inward
  • Swollen lymph nodes under arm or above collarbone

How IBC is Diagnosed:

Your doctor will do a clinical breast exam, including a visual check of your breast.  The doctor will look for skin color changes that may be caused by cancer cells blocking the lymph nodes and vessels in your breast skin.  If your breast is swollen, it may be caused by fluid buildup, a condition called edema. Your doctor will check the lymph nodes nearest your breast, sites to which cancer cells may travel. If your breast skin is ridged, pitted, bumpy, or resembles an orange peel, that will also be noted. These symptoms can develop quickly, sometimes seemingly overnight and sometimes taking a few weeks or months.

Confirming a Diagnosis of IBC:

Based on a clinical breast exam, your doctor will make a diagnosis of IBC, but it should be confirmed by other tests. Because IBC can appear to be other conditions, such as mastitis, it's important to follow through with these additional tests.

  • Mammogram - to check for tumor or skin thickening and increased breast density
  • Ultrasound - for axillary lymph nodes and breast masses
  • Breast biopsy or skin biopsy
  • MRI - images breast masses and skin changes
  • CAT and PET Scan - images of soft tissue, bone, and blood vessels and lymph nodes, possible sites of metastasis

Growth of IBC:

Inflammatory breast cancer commonly grows in nests or sheets, not in lumps. IBC spreads through the body, beyond the breast, via the lymph system.  It can appear to be a slow-growing low grade tumor – but once the breast's skin looks inflamed, it can be confirmed as a more advanced cancer that has rapidly metastasized to the surface.

Stages of IBC:

IBC is always classified as Stage 3b or Stage 4 breast cancer. Stage 3b means that the cancer is larger than 5cm, is in at least one lymph node, and has not spread to other parts of your body. Stage 4 means that the cancer is in the chest wall and/or skin, lymph nodes are involved, and it has spread to other organs. It is important to know your cancer stage, because it influences your treatment plan and your chances of recurrence and survival.

Treatments For IBC:

Inflammatory breast cancer is aggressive, and must be treated appropriately. Your first line of attack will be neoadjuvant chemotherapy, which is given before surgery. You will be carefully monitored to see how your cancer is responding to the treatment. Possible treatments for IBC may include:

Risk of IBC Recurrence:

IBC has a higher risk of recurrence than other kinds of breast cancer.  Statistics show that the 5-year survival rate for IBC patients is between 25 and 50 percent, much lower than the survival rate for patients with other types of breast cancer.  Each case is unique, so discuss your prognosis with your doctor, to get a better idea of your situation. If you have been diagnosed with Stage 3b IBC and take effective treatments, you may be able to live longer and have a better quality of life after diagnosis. If arrested early, IBC can be treated as a chronic disease, and a patient may become a long-term survivor.

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Sources:

Inflammatory Breast Cancer.  Cancer Reference Information.  American Cancer Society. Last Revised: 09/02/2009

Inflammatory Breast Cancer: Questions and Answers. National Cancer Institute. Reviewed: 08/29/2006.

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