Inflammatory Breast Cancer

Have you ever heard of the disease Inflammatory Breast Cancer (IBC)? It is one type of breast cancer known as IBC, an abbreviation for Inflammatory Breast Cancer. It is not very common compared to other types of cancers, and it is difficult to diagnose in its early stages. What is Inflammatory Breast Cancer? What are its symptoms? What are its causes? These and many more questions that may come to your mind will be found in the following lines.

1- What is Inflammatory Breast Cancer?

Inflammatory Breast Cancer is one of the rare types of breast cancer, where cancer cells block the lymph vessels in the breast skin. This results in swelling and redness of the breast, giving the appearance of inflammation. This type of cancer grows rapidly, often developing within weeks or months, requiring immediate treatment. According to the American Cancer Society, Inflammatory Breast Cancer represents approximately 1 to 5% of all breast cancer diagnoses.

2- Causes of Inflammatory Breast Cancer

Inflammatory Breast Cancer occurs for unclear reasons, and despite its name, it does not actually result from inflammation. It is known that Inflammatory Breast Cancer begins with an abnormal cell developing in the milk duct. Due to mutations in its DNA, this cell grows and divides at a very rapid pace.

The accumulation of cancer cells can block the lymph vessels in the breast skin, hindering lymphatic drainage and allowing the buildup of fluids within the breast. Sometimes, cancer cells may spread or metastasize to lymph nodes, tissues, and organs throughout the body.

3- Symptoms of Inflammatory Breast Cancer

Inflammatory Breast Cancer typically does not present as a lump, as is the case with other forms of breast cancer. Instead, signs and symptoms of Inflammatory Breast Cancer include the following:

• Rapid change in the appearance of one breast over several weeks.
• Noticeable thickening or swelling in one of the breasts.
• Change in the color of the breast, appearing reddish, purplish, pink, or with the appearance of bruising.
• Unusual warmth in the affected breast.
• Appearance of dimples or protrusions on the skin of the affected breast, resembling orange peel.
• Constant pain and itching.
• Swelling of lymph nodes under the arm, above or below the collarbone.
• Flattening or inversion of the nipple.

4- How is Inflammatory Breast Cancer Detected?

Despite its noticeable symptoms such as breast pain, red patches, and others, it is very challenging to diagnose IBC through some tests. Therefore, in most cases, Inflammatory Breast Cancer has often reached advanced stages, such as stage three or four, before being discovered during an examination. However, these tests are typically conducted:

• Physical examination: Since lumps usually do not form with Inflammatory Breast Cancer, the doctor may look for redness or other signs indicating it.
• Mammogram: A mammogram uses low-energy X-rays to create an internal image of the breast. This allows the doctor to look for signs of breast cancer, such as skin thickness.

Additionally, ultrasound imaging of the breast uses sound waves to create images of the breasts from the inside and nearby tissues and lymph nodes. These waves help determine whether the cancer has spread further into nearby tissues or not. However, IBC inflammations often appear similar to breast infections in imaging.

Biopsy: This may be the only way to confirm the diagnosis of IBC. During a biopsy, the doctor removes a sample of tissue from the breast, which is then tested to determine if these tissues are cancerous. Biopsy results may determine the cancer stage or whether it has spread beyond the breast tissues.

In addition to these tests that may not confirm the diagnosis of Inflammatory Breast Cancer, there are some criteria that also help in diagnosing the disease, including:

• Rapid onset of redness, swelling, and an unusual warmth sensation in the breast.
• Persistence of the mentioned symptoms for less than 6 months.
• Redness covering at least one-third of the breast.
• Initial biopsy samples from the affected breast showing invasive cancer, meaning cancer cells have appeared, developed, and grown from the lining of the ducts in breast tissues to the surrounding breast tissues.

5- What are the complications of Inflammatory Breast Cancer?

The treatment of IBC may cause complications, such as lymphedema, which is the accumulation of lymphatic fluid after a surgical procedure to remove lymph nodes. Since Inflammatory Breast Cancer develops rapidly, the cancer typically spreads to other tissues by the time of diagnosis. The patient may require additional treatments if the cancer has spread to other parts of the body.

6- Is recovery possible from Inflammatory Breast Cancer?

Inflammatory Breast Cancer tends to grow rapidly, and it is likely to have spread by the time it is discovered. It is also possible for it to recur after treatment more frequently than many other types of breast cancer. For this reason, overall survival and recovery rates are not as high as for other types of breast cancer.

7- Treatment of Inflammatory Breast Cancer

chemotherapy to help shrink the tumor, followed by surgery to remove the tumor, and then radiation therapy. The treatments used in the multimodal approach may include the following:

• Neoadjuvant chemotherapy: This type of chemotherapy is administered before surgery and usually involves anthracycline and taxane drugs. Generally, doctors recommend giving at least 6 sessions of neoadjuvant chemotherapy over 4 to 6 months before tumor removal, unless the disease continues to progress during this time, and doctors decide not to delay surgery.
• Targeted therapy: Inflammatory breast cancers often produce higher-than-normal amounts of the HER2 protein, making drugs like trastuzumab (Herceptin), which target this protein, suitable for treatment. Anti-HER2 therapy can be given as part of neoadjuvant therapy and after surgery.
• Hormone therapy: If the cells of inflammatory breast cancer in women contain hormone receptors, hormonal therapy is another treatment option. Medications such as tamoxifen, which prevents estrogen from binding to its receptors, and aromatase inhibitors like letrozole, which inhibit the body’s ability to produce estrogen, can cause hormone-receptor-positive cancer cells to stop growing and die.
• Surgery: This surgery involves the complete removal of the affected breast and most or all of the lymph nodes under the adjacent arm. Often, the lining above the core chest muscles is also removed, but the chest muscles are preserved. However, the small chest muscle may also be removed.
• Radiation therapy: Post-mastectomy radiation therapy is a standard component of multimodal treatment for Inflammatory Breast Cancer. If a woman received trastuzumab before surgery, she may continue to receive it during radiation therapy after the surgical procedure.
• Adjuvant therapy: Systemic adjuvant therapy may be given after surgery to reduce the chances of cancer recurrence. This therapy may include additional chemotherapy, hormonal therapy, targeted therapy (such as trastuzumab), or a combination of these treatments.

Tip: Don’t wait for October, the global awareness month for breast cancer, to remember and undergo breast imaging, also known as mammography. On the contrary, don’t overlook such an important matter; it’s about your life!

All you need to do is jot down this note on your phone or even write it on a piece of paper and stick it on the fridge: “Must undergo breast imaging once a year.” Be confident that early detection can save your life before cancer cells spread throughout your body.

Never neglect this crucial step, and don’t postpone it no matter how busy you are with work or family life. Every year, go with your mother, sister, or friend for the initial screenings, to find out whether the results are negative or positive. If negative, be assured that your chances of recovery from breast cancer, especially in its early stages, will be extremely high.