Inflammatory Breast Cancer

Time and time again, women are told to perform self-breast exams in order to detect a lump, which could be a sign of breast cancer. While these self-exams are vitally important, as they can help you detect early stage breast cancer, not all types of breast cancer cause the formation of a lump in your breast. In fact, one of the deadliest forms of breast cancer produces symptoms that are atypical of common breast cancer signs and may even cause you to be misdiagnosed. A particularly aggressive form of breast cancer, inflammatory breast cancer is fairly rare, accounting for between 1% and 4% of all breast cancer diagnosis.

What is Breast Cancer?
Cancer forms in our bodies when our cells begin to grow at an accelerated pace. Individuals affected by breast cancer will have their breast cells multiple and mutate out of control, resulting in the formation tumors deep within your breast. While the reason for the excessive growth is unknown, various types of treatment are available to help kill off the cancerous cells.

Breast cancer affects 216,000 people every year in the United States alone, making it the most common type of cancer to affect women. Although breast cancer is typically thought to be more prevalent among menopausal women over the age of 50, one in four women diagnosed with breast cancer will be in her childbearing years. Additionally, one in every 100-breast cancer patient is male.

How is Inflammatory Breast Cancer Different?
Although it is a type of breast cancer, inflammatory breast cancer differs from typical breast cancer in various ways. Perhaps the most notable difference is the fact that women with inflammatory breast cancer often do not have a detectable lump. This is due to the fact that inflammatory breast cancer, or IBC, develops in sheets just below the breast�s skin and affects the entire breast. Additionally, cancer cells block the lymphatic system, hindering normal drainage of lymphatic fluid. Due to this block, the breast becomes swollen and inflamed (hence the name inflammatory breast cancer).

Inflammatory breast cancer grows rapidly and spreads to other areas of the body quickly. Unlike breast cancer, which can progress through five different stages, inflammatory breast cancer is generally considered to be a stage 3 breast cancer at diagnosis, unless it has already spread to other areas of the body, in which case it is considered to be a stage 4 breast cancer. Because this type of cancer is so aggressive, immediate treatment is necessary and usually involves chemotherapy, surgery, radiation therapy and possibly additional chemotherapy.

Symptoms of Inflammatory Breast Cancer
While the signs of breast cancer are typically noticeable, and include a lump in the breast area, pain in the breasts and discharge from the nipples, IBC causes entirely different symptoms. IBC symptoms generally emerge quickly, over a period of a few weeks. Moreover, these symptoms are often mistaken for mastitis, a normal breast infection that commonly affects lactating women. This fact is particularly troublesome when one considers that many women who develop IBC at a young age experience their first symptoms while they are pregnant or breastfeeding.

Typical symptoms of IBC include:

• Sudden swelling (possible to increase a cup size in just a few days)
• Ridged or pitted appearance of the breast, similar to an orange peel (known as peau d�orange)
• Breast feels warm to the touch
• Pain in breast
• Itching
• Discoloration (pink, red or bruised appearance that won�t go away)
• Discharge from the nipple
• Sudden inversion of the nipple
• Aureole changes in color and texture

Additionally, if a mammogram reveals an increase in your breast�s density since your last mammogram, you should consider this to be unusual and request further investigation by your doctor.

Diagnosing Inflammatory Breast Cancer
Diagnosing breast cancer is usually dependant upon a lump: a woman or her doctor finds a lump; part of the lump is sent for biopsy to determine whether it is malignant and appropriate treatment is prescribed. However, in the case of IBC, rarely is there a palpable lump present or any type of lump that can be detected through ultrasound or mammograms. Because the symptoms of IBC are so similar to mastitis, it is more likely that a woman will be misdiagnosed and prescribed antibiotics instead.

Occasionally, the use of antibiotics may alter the appearance of symptoms, which can cause both you and your doctor to think that they are having some affect. The use of antibiotics does not help treat IBC at all and only serves to delay a proper diagnosis. If you are displaying symptoms of inflammatory breast cancer and have been prescribed antibiotics, insist on further investigation and a breast biopsy if your symptoms have not improved after a few weeks.

Diagnosing IBC can be difficult since the cancer is not apparent on ultrasounds or mammograms. Generally, the only way to definitively diagnose inflammatory breast cancer is through a biopsy. In this procedure, a small portion of your breast tissue is removed and examined under a microscope for cancerous cells.

Treating Inflammatory Breast Cancer
Because IBC is considered to be an advanced form of breast cancer and progresses quickly through the body, aggressive treatment is normally prescribed. Typically, treatment for IBC involves chemotherapy, surgery, possibly chemotherapy again and radiation therapy. However, the treatment you receive can vary depending on your doctor and the progression of the cancer at the time of diagnosis. Although normally prescribed to menopausal women, hormonal treatment may also be recommended. This can be done alongside or in place of chemotherapy.

While this course of treatment may seem like overkill, it is necessary to ensure that all cancer cells have been destroyed. IBC can rapidly spread to the rest of body; therefore chemotherapy is required. Chemotherapy helps to kill off all the cancer cells throughout the body. Surgery and radiation therapy are then performed to focus on the cancer cells that are present in the breast.

Prognosis
In the past, the prognosis for women with IBC was not good. The average life expectancy rate after diagnosis was about 18 months. However, breast cancer treatments have improved greatly over the last number of years causing breast cancer survival rates to increase as well. While breast cancer statistics for inflammatory breast cancer are still not stellar, the five-year survival rate stands at about 40%.