What Is Inflammatory Breast Cancer?

This rare and aggressive type of breast cancer comes with unique symptoms and risk factors.

Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer that has spread to the breast skin. About 1% to 5% of all breast cancer cases are IBC.

Healthcare providers diagnose IBC at advanced stages, including stages 3 and 4, since cancer cells have grown into the skin. At stage 3, healthcare providers can possibly cure IBC. In contrast, at stage 4, cancer has metastasized, or spread, to distant organs, and IBC is incurable. At stage 4, treatment focuses on reducing symptoms and prolonging life.

IBC typically doesn't come with a lump, one of the most common signs of other breast cancers. Instead, you may experience the following:

  • Redness
  • Inflammation
  • Dimpling (when breast skin has an orange peel texture)  

Healthcare providers often mistake IBC for other skin diseases, like mastitis or cellulitis, because of similar symptoms. Here's what you need to know about the early signs and symptoms of IBC to help properly prevent, diagnose, and treat the rare type of breast cancer.

What Causes Inflammatory Breast Cancer? 

Breast cancer occurs when changes in your genetic material, DNA, cause cells in the breast tissue to grow out of control.

Like all cancers, breast cancer is related to both genetic and epigenetic abnormalities. You may inherit genetic mutations, such as a BRCA mutation. In contrast, epigenetic factors are behavioral and environmental influences on how your genes work.

Also, some lifestyle and environmental factors can play a role, such as:

  • Drinking alcohol
  • Having an early period
  • Radiation exposure  

Research has found some unique risk factors for IBC. Still, researchers don't know why some people develop IBC. Family history may play a more minor role in IBC than other types of breast cancer, according to a study published in 2016 in BMC Cancer.

Risk Factors

Generally, risk factors for breast cancer include:

  • Being female
  • Drinking alcohol
  • Having prior radiation therapy to the chest or breast
  • Getting your period at an earlier age than average

IBC comes with some different risk factors than other types of breast cancer. For example, people may develop IBC younger than other types of breast cancer. Also, most people with IBC have dense breast tissue, which makes diagnosis harder than normal.

Also, people who've breastfed after giving birth may have less aggressive IBC than others, according to a study published in 2017 in the Journal of Cancer.

Symptoms of Inflammatory Breast Cancer 

People often describe IBC as a "bug bite" or "heat rash" that rapidly evolves to cover at least one-third of the breast tissue. In fact, some healthcare providers may mistake IBC for a skin infection or allergic reaction.

In addition to swelling and redness, IBS symptoms include:

  • Skin that thickens and starts dimpling to look like an orange peel
  • One-sided changes in breast size and weight
  • nipple that retracts or goes inward
  • Warm, painful, tender, or itchy breast  

Swollen lymph nodes under the arm or near the collarbone may also signal breast cancer. 

IBC symptoms develop within three to six months, which is less than the time the American Cancer Society (ACS) recommends between preventive breast mammogram screenings. So, IBC is harder to catch early than normal.

IBC symptoms, like swelling and redness, can come from diseases or conditions much less serious than IBC. So, consulting a healthcare provider if you experience those symptoms is key.

How Is Inflammatory Breast Cancer Diagnosed? 

Healthcare providers diagnose IBC by doing the following:

  • Ordering a mammogram
  • Following up with an ultrasound of the breast and nearby lymph nodes
  • Ordering a biopsy to confirm a diagnosis, if needed
  • Conducting more imaging tests, such as PET, CT, or bone scans, to see how far the cancer has spread

Early diagnosis of IBC is crucial. However, diagnosing IBC may be challenging. A mammogram is less likely to detect IBC than other types of breast cancer because it presents without a lump. Also, in most people with IBC, the breast tissue is dense.

With IBC, symptoms such as redness, swelling, dimpling, and unusual warmth usually come on fast. They must be present for less than six months, and the redness must cover at least a third of the breast.

Breast Cancer Screening Guidelines

Breast Cancer Screening Guidelines: As of May 2023, the U.S. Preventative Services Task Force (USPSTF) recommends that cisgender women and people assigned female at birth get mammograms every two years beginning at age 40. This is 10 years earlier than the current guidelines. More research is needed on whether people with dense breasts should have additional screenings as well as the potential benefits and risks of screening people older than 75.

Treatment for Inflammatory Breast Cancer 

Typically, IBC treatment begins with chemotherapy. Chemotherapy includes drugs that healthcare providers administer intravenously. Or you can take those drugs orally. The drugs destroy cancer cells throughout the body.

Common side effects of chemotherapy include:

  • Hair loss
  • Mouth sores
  • Fatigue
  • Diarrhea
  • Loss of appetite
  • Weight changes
  • Hot flashes

Because chemotherapy targets cells all over the body, the drugs can also affect cells in the bone marrow. People doing chemotherapy may notice easier bruising or bleeding and a higher risk of infection than normal.

However, IBC is aggressive. So, in addition to chemotherapy, healthcare providers often combine different treatments, which may include:

  • Surgery: Because the cancer is in the skin, healthcare providers typically perform a radical mastectomy. That surgery removes the whole breast and nearby lymph nodes. Another surgery may rebuild the breast. However, a healthcare provider may advise delaying that procedure if you need radiation therapy.
  • Radiation therapy: After surgery, healthcare providers typically administer radiation therapy. Radiation therapy uses high-energy rays or particles to get rid of cancer cells. Healthcare providers may also use radiation therapy and a new round of chemotherapy before surgery if the original round didn't completely reduce redness.
  • Hormone therapy: The goal of hormone therapy is to stop cancer cells with estrogen receptors. For example, tamoxifen is a drug that keeps estrogen from binding to those receptors. Also, letrozole is a drug that stops the body from making estrogen. 
  • Other drug therapies, such as targeted agents: With some cases of IBC, the body makes more HER2, a protein, than normal. Targeted agents, like Herceptin (trastuzumab), can treat those cases.
  • Clinical trials: Ongoing clinical trials may provide additional options for people with IBC. People can search for their condition in the National Cancer Institute (NCI)'s clinical trials database.

How To Prevent Inflammatory Breast Cancer 

While it's impossible to prevent IBC entirely, early diagnosis is crucial to treating the cancer. 

Generally, some steps you can take to reduce your risk of breast cancer include:

  • Maintaining a healthy weight
  • Regularly exercising
  • Moderating your alcohol consumption
  • If you've given birth, breastfeeding for several months 

Also, you can take other preventive steps if you have a high risk of breast cancer because of family history, genetic mutations, or other lifestyle factors. Those steps may include the following:

  • Paying close attention to symptoms
  • Getting medical checkups every six to 12 months
  • Starting annual mammograms and breast MRIs as early as 30 
  • In some cases, taking medications such as Nolvadex (tamoxifen), Evista (raloxifene), or aromatase inhibitors
  • Surgically removing the breasts or ovaries

However, those steps depend on your risk of developing IBC or other types of breast cancer. So, discussing your risk and options with a healthcare provider is essential.

Getting an IBC diagnosis can be scary, but treatments are improving. Researchers are looking into more risk factors. Pay attention to your body, and speak to a healthcare provider if you feel something is off.

A Quick Review

IBC is a rare and aggressive form of breast cancer that has spread to the skin. IBC often begins as what looks like a bug bite or heat rash that quickly evolves into redness and swelling, enveloping at least one-third of your breast. 

Early detection is key to successful treatment. So, talk to a healthcare provider right away if you have symptoms or concerns.

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16 Sources
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