Inflammatory Breast Cancer

At the UofL Brown Cancer Center, we treat women with inflammatory breast cancer, both those who have been treated before and those who are newly diagnosed.

Overview

Inflammatory breast cancer (IBC) is rare, and it can be fast-growing and dangerous.

IBC represents only 1 to 5 percent of all invasive breast cancer cases in the United States, but due to its aggressive nature, it represents 10 percent of U.S. breast cancer deaths. Early and accurate inflammatory breast cancer diagnosis and personalized treatment by experts who specialize in IBC can make an important difference.

In our Multidisciplinary Breast Cancer Clinic we treat women with inflammatory breast cancer, both those who have been treated before and those who are newly diagnosed.

Our team is highly skilled in diagnosing inflammatory breast cancer. Doctors from many disciplines work in teams to customize your treatment, and use the most-advanced techniques and technology. It’s essential to establish a comprehensive and personalized treatment plan for inflammatory breast cancer (IBC) as early as possible. For this reason, our team approach, which brings together experts from many specialties, is extremely important.

We are still learning about inflammatory breast cancer, and recent studies show the best treatment often is based on each cancer’s specific genetic and biological makeup.

Inflammatory breast cancer may also be called:

  • Locally advanced breast cancer
  • Breast carcinoma with dermal lymphatic invasion
  • Inflammatory carcinoma of the breast

As a patient at UofL Brown Cancer Center, you are the focus of some of the most talented and experienced physicians in the region.

Inflammatory breast cancer is rare, and it is the most aggressive form of breast cancer. According to the American Cancer Society, it accounts for only 1 to 5 percent of all invasive breast cancers. However, the five-year inflammatory breast cancer survival rate is 40 percent, compared to nearly 90 percent for all other types of breast cancer combined.

Inflammatory breast cancer may also be called:

  • Locally advanced breast cancer
  • Breast carcinoma with dermal lymphatic invasion
  • Inflammatory carcinoma of the breast

The symptoms of IBC actually are not caused by inflammation but by cancer cells blocking lymph vessels in the skin and soft tissue. Lymph is a clear fluid that contains tissue waste and cells that help fight infection. It travels through the body in vessels that are similar to veins. Lymph nodes are small, bean-shaped organs that link lymph vessels.

Some cases of inflammatory breast cancer can be passed down from one generation to the next. Genetic counseling may be right for you.

Symptoms

Unlike the signs of most other breast cancers, inflammatory breast cancer (IBC) symptoms progress very quickly, often within days or weeks. Inflammatory breast cancer quickly covers the breast in sheets, causing redness, tenderness and thickening of the skin. Most women with IBC never find a lump.

Inflammatory breast cancer symptoms vary from person to person. If you have symptoms, they may include:

  • Breast swelling that appears suddenly with one breast much larger than the other
  • Itching of the breast
  • Pink, red, or dark colored area on the breast, sometimes with a dimpling of the breast skin that looks like an orange peel (called peau d’orange)
  • Ridges and thickened areas of the skin on the breast
  • Breast that feels warm to the touch
  • Flattened or retracted nipple
  • Breast pain or tenderness

These symptoms usually do not mean you have inflammatory breast cancer.  However, if you notice any of these symptoms, it is important to discuss them with your doctor, since they may signal other health problems.

Diagnosis

Early diagnosis of inflammatory breast cancer (IBC) greatly increases your chances for successful treatment.

Since symptoms of IBC often are similar to those of breast infection (mastitis), your doctor first may prescribe antibiotics. If the symptoms do not improve or grow worse, you should have diagnostic tests as soon as possible. These may include:

  • Mammogram and MRI mammography
  • Ultrasound of the breast and lymph nodes
  • Biopsy (removal of a small piece of tissue that is examined under a microscope) of any mass, enlarged lymph node and/or breast skin

In most cases of inflammatory breast cancer, a mammogram will not reveal a distinct breast lump but may show skin thickening or enlarged lymph nodes. If a biopsy confirms cancer cells are present, more imaging scans and possibly more biopsies may be needed to get an accurate picture of the disease.

Inflammatory breast cancer (IBC) staging

Staging is a way of classifying cancer by how much disease is in the body and where it has spread when it is diagnosed. This helps the doctor plan the best way to treat the cancer. The stage of the cancer stays the same even if treatment works or the disease spreads.

IBC is considered Stage IIIB or IIIC upon diagnosis. If the cancer has spread to distant areas (metastasized) such the liver, lung or brain, it is a Stage IV cancer.

It’s essential to establish a comprehensive and personalized treatment plan for inflammatory breast cancer (IBC) as early as possible. For this reason, our multidisciplinary team approach at UofL Brown Cancer Center, which brings together experts from many specialties, is extremely important.

As a patient in our breast clinic, you are the focus of some of the most talented and experienced physicians in the world. They communicate and collaborate often about your treatment, which depends on several factors. Your treatment for inflammatory breast cancer will be customized to your needs. One or more of the following therapies may be recommended to treat the cancer or help relieve symptoms.

Chemotherapy

The goal of chemotherapy is to eliminate or reduce inflammatory breast cancer before surgery. Using chemotherapy before surgery is call neoadjuvant or primary chemotherapy. We offer the most up-to-date and effective chemotherapy options. Women with IBC usually receive a combination of at least two drugs. Chemotherapy should be started as soon as possible to prevent the spread of the disease.

Surgery

Because inflammatory breast cancer usually does not have a distinctive breast lump, surgery to remove just the cancerous tissue (lumpectomy) is not possible. A complete mastectomy (removal of the entire breast) usually is needed to remove all the affected areas.

The surgeon looks at lymph nodes close to the breast during surgery, and nearby lymph nodes are removed in most cases. Breast reconstruction usually is not recommended initially after surgery for IBC. It is best to wait until therapy has been completed and there is no evidence of disease.

Like all surgeries, breast cancer surgery is most successful when performed by a specialist with a great deal of experience in the particular procedure. The breast surgeons at UofL Brown Cancer Center are among the most skilled and renowned in the world. They perform a large number of surgeries for inflammatory breast cancer each year, using the most-advanced techniques.

Radiation therapy

After chemotherapy and surgery, radiation therapy may be performed on the chest wall and lymph nodes. Radiation helps control disease and reduce the risk of it coming back. It also may be used to treat IBC that has spread, to manage pain or to help you feel better if you cannot have surgery.

New radiation therapy techniques and remarkable skill allow our doctors to target tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.

Targeted therapies

Targeted therapies use the cancer’s specific genetic or biological makeup to help the body attack the disease. We are among a select group of cancer centers in the nation that offer targeted therapies for inflammatory breast cancer.

Hormone therapy

If inflammatory breast cancer is hormone-receptor positive (estrogen receptor [ER] or progesterone receptor [PR]), you may need hormone therapy. These oral medicines stop the body from making or activating estrogen and progesterone. Doctors choose the best type of hormone therapy depending on your menopause status.

Stem cell transplant

For some patients with inflammatory breast cancer, a stem cell transplant may be an option after initial therapy or if the disease spreads, with the goal to reduce the chance of the cancer returning.

Our doctors at UofL Brown Cancer Center are proudly part of UofL Physicians and the UofL School of Medicine.

We believe knowledge comes from questioning the status quo, discovering more about disease and using that knowledge to improve the health of our community. Our physicians are the teachers and researchers at the UofL School of Medicine, involved in the research and development of new treatments and cures for cancer. This means you receive the most advanced and appropriate treatment, even for complex or rare conditions.

To learn more about the physicians who make the academic difference in treatment for inflammatory breast cancer, visit the UofL Physicians website here.