Inflammatory breast cancer (IBC) is rare and accounts for only 1-5% of all breast cancers. Although it is often a type of invasive ductal carcinoma, it differs from other types of breast cancer in its symptoms, outlook, and treatment. IBC has symptoms of inflammation like swelling and redness, but infection or injury does not cause IBC or the symptoms. IBC symptoms are caused by cancer cells blocking lymph vessels in the skin causing the breast to look "inflamed."

Symptoms include breast swelling, purple or red color of the skin, and dimpling or thickening of the skin of the breast so that it may look and feel like an orange peel. Often, you might not feel a lump, even if it is there. If you have any of these symptoms, it does not mean that you have IBC, but you should see a doctor right away.

Signs and symptoms of inflammatory breast cancer

Inflammatory breast cancer (IBC) causes a number of signs and symptoms, most of which develop quickly (within 3-6 months), including:

• Swelling (edema) of the skin of the breast
• Redness involving more than one-third of the breast
• Pitting or thickening of the skin of the breast so that it may look and feel like an orange peel
• A retracted or inverted nipple
• One breast looking larger than the other because of swelling
• One breast feeling warmer and heavier than the other
• A breast that may be tender, painful or itchy
• Swelling of the lymph nodes under the arms or near the collarbone

Diagnosis

Imaging tests

If inflammatory breast cancer (IBC) is suspected, one or more of the following imaging tests may be done:

• Mammogram
• Breast ultrasound
• Breast MRI (magnetic resonance imaging) scan

Biopsy

Tests on biopsy samples

The cancer cells in the biopsy will be examined in the lab to determine their grade.

They will also be tested for certain proteins that help decide which treatments will be helpful. Women whose breast cancer cells have hormone receptors are likely to benefit from treatment with hormone therapy drugs.

Cancer cells that make too much of a protein called HER2 or too many copies of the gene for that protein may be treated by certain drugs that target HER2.

Stages of inflammatory breast cancer

All inflammatory breast cancers start as Stage III (T4dNXM0) since they involve the skin. If the cancer has spread outside the breast to distant areas it is stage IV. 

Treating inflammatory breast cancer

Inflammatory breast cancer (IBC) that has not spread outside the breast or nearby lymph nodes is stage III. In most cases, treatment is chemotherapy first to try to shrink the tumor, followed by surgery to remove the cancer. Radiation is given after surgery, and, in some cases, more treatment may be given after radiation. Because IBC is so aggressive, breast conserving surgery (lumpectomy) and sentinel lymph node biopsy are typically not part of the treatment.

IBC that has spread to other parts of the body (stage IV) may be treated with chemotherapy, hormone therapy, and/or with drugs that targets HER2.

• Chemotherapy (possibly along with targeted therapy)
• Surgery and further treatments

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Journal of Cancer Research and Immuno-Oncology

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