Inflammatory breast cancer is rare but aggressive: Know the signs

Inflammatory breast cancer is rare, but it's aggressive, fast-growing and hard to detect early, so it's important to know the warning signs.

The American Cancer Society is working to raise awareness about this form of breast cancer, known also as IBC, which is responsible for about 1% to 5% of all breast cancer cases.

"IBC is tricky as it doesn't usually present with a breast lump like many women expect when they think of a breast cancer. Instead, the disease causes inflammatory symptoms, like swelling and redness as cancer cells block lymph vessels in the skin," said Dr. William Dahut, chief scientific officer at the American Cancer Society.

"These symptoms may show up quickly—over just three to six months, so if you experience them, it is important to investigate with your health care team right away," Dahut said in a cancer society news release.

Also unusual, IBC may not show up on a mammogram.

All cases of IBC are considered advanced to at least stage 3 because it can grow and spread more quickly than other forms of breast cancer and involves the skin.

By the time IBC is diagnosed, in about one-third of cases it has already spread to distant parts of the body. Those at risk for IBC are women under age 40, Black women and those who are overweight or obese.

What to look for

Warning signs include swelling of the skin of the breast, redness involving more than one-third of the breast and a pitting or thickening of the skin of the breast so that it may look and feel like an orange peel.

Other signs are a retracted or inverted nipple, one breast appearing larger than the other or feeling warmer and heavier than the other, and a breast that may be tender, painful or itchy.

Swelling of the lymph nodes under the arms or near the collarbone can also be a sign.

Some of these symptoms can also signal an infection, so a doctor may initially treat a patient with antibiotics before doing more tests if symptoms don't clear.

IBC should be considered as a stronger possibility if a woman with symptoms is not pregnant or breastfeeding or has already gone through menopause, according to the cancer society.

What next?

Diagnosis involves imaging tests like a mammogram, breast ultrasound or breast MRI, as well as a biopsy of breast tissue. That means removing a small piece of breast tissue for evaluation in a lab.

If IBC has not spread beyond the breast, treatment usually begins with chemotherapy, followed by surgery to remove the cancer. Radiation and other more targeted drug therapies are given after surgery, the cancer society said.

If IBC has spread, it is treated with chemotherapy, hormone therapy and targeted drug therapy.

"There is encouraging news in the form of new drugs and treatment combinations for IBC," Dahut said. "Specific drug combinations or combinations of drugs and radiation therapy are being tested to help keep the cancer from returning. For advanced disease, treatments that include new targeted therapies are being studied and certain immunotherapy drugs have already been approved for treatment of IBC that is triple negative."

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