The diagnosis challenge
The deadliest breast cancer can also be the hardest to diagnose. Inflammatory breast cancer often has no lump, and the cancerous area may not appear on a mammogram. Symptoms mimic those of a breast infection, such as breast pain, swelling and itching and enlarged lymph nodes.
If you have symptoms that suggest IBC, your healthcare provider may schedule a biopsy, which analyzes a sample of skin and breast tissue. If a biopsy confirms IBC, additional tests, such as chest X-rays, CT scans and bone scans, can determine whether the cancer has spread.
Reduce your breast cancer risk
Inflammatory breast cancer doesn’t behave like other forms of breast cancer, nor has science definitively determined its risk factors, so preventive measures may not apply. But that doesn’t mean you shouldn’t enjoy a healthier lifestyle with these general breast cancer prevention tips:
- Curb alcohol intake. The alcohol-breast cancer link is strong. Limit yourself to less than one drink a day or none at all.
- Maintain a healthy weight. Weight gained later in life, especially after menopause, can increase your chances of developing breast cancer.
- Keep moving. Exercise helps you maintain a healthy weight, which in turn can lower your cancer risk. Aim for at least 30 minutes of moderate walking, jogging or aerobics on most days.
- Limit fats in your diet. Although data suggest only a slight decrease in cancer risk for women who eat a low-fat diet, limiting your fat intake helps you maintain a healthy weight. To get the most benefits, limit total fats to less than 35 percent of your daily calories and steer clear of saturated fats.
- Talk to your healthcare provider about hormone replacement therapy risks and benefits. The Women’s Health Initiative study linked an increased risk of breast cancer—including more aggressive tumors—to women who took estrogen-progestin combinations for menopause symptoms. Consider alternatives like diet, exercise and nonhormonal therapies to give you some relief. Or your doctor may recommend a lower dose for a shorter period of time.
While a lump is one classic sign of breast cancer, not every form of the disease bears this warning sign. Inflammatory breast cancer (IBC) is a rare but deadly cancer that often remains silent until it has spread.
IBC appears earlier than other breast cancers—on average, about age 52—and accounts for up to 5 percent of all breast cancer cases in the United States. Although its prognosis has improved over the years, its five-year survival rate of 25 percent to 50 percent is still lower than that of other breast cancers. Some studies have suggested family history may play a role in a woman’s risk of developing the aggressive disease.
Despite its name, IBC isn’t a product of inflammation. Rather, it occurs when cancerous cells block the lymphatic vessels in a breast’s skin. Instead of a lump, you may notice that certain areas of the breast’s skin feel warm, appear red or bruised or look thicker. Your breast might also feel heavy. Other symptoms that develop in an affected breast include:
- tenderness or swelling
- skin texture like an orange peel
- a flattened or inverted nipple
- swollen or crusty nipple skin
- discoloration of skin around the nipple (areola)
- enlarged lymph nodes under the arm or above or below the collarbone
IBC symptoms can easily be confused with a breast infection. However, IBC doesn’t cause a fever and doesn’t respond to antibiotics like an infection does. If you’re experiencing any of the symptoms listed, contact your healthcare provider immediately. Because the disease spreads rapidly—changes in your breast can become noticeable in a matter of days—many women already have an advanced stage of IBC by the time it’s diagnosed.
Oncologists often combine chemotherapy, surgery and radiation therapy to treat IBC. Removal of the affected breast is often recommended following a treatment such as chemotherapy.
The recurrence rate for IBC is high. Additional chemotherapy or hormone therapy such as tamoxifen or anastrozole may be prescribed to help prevent the cancer from returning.
Although IBC is associated with a high mortality rate, the more you know about it, the better your shot at recognizing its symptoms and seeking help when treatment may be most effective.