Kelly Furda, MD
(Dr. Furda is a radiologist at the Park Nicollet Jane Brattain Breast Center)
With 1 in 8 women developing breast cancer in their lifetime, you likely know someone who’s had breast cancer or maybe experienced it yourself. In the United States, breast cancer is the 2nd most common cancer in women after skin cancer. The good news is that improvements in screening, early detection and treatments, have resulted in a decline in breast cancer mortality rates since about 1990.
A rare subtype of breast cancer that many are not aware of is inflammatory breast cancer (IBC). This subtype is called “inflammatory” because the breast tends to look inflamed – swollen and red. Usually there is not a lump that can be felt, but an abnormality can typically be seen on breast imaging. Women with IBC often notice the skin on their breast is pink or red. The skin also might have a thick, pitted appearance like an orange peel. The breast may feel tender and heavy. Symptoms can easily be confused with a breast infection. If this is IBC, the changes are actually caused by cancer cells blocking lymph vessels in the skin.
Fortunately, inflammatory breast cancer is one of the least common types, accounting for about 1% to 3% of all breast cancers, but it progresses rapidly, often in a matter of weeks or months. Because the symptoms can also be signs of infection, women with inflammatory breast cancer can have a delayed diagnosis of their disease.
So how is inflammatory breast cancer diagnosed and staged? Most of the time IBC is diagnosed after a woman sees and feels the changes (as mentioned above) to her breast and consults with her doctor. Occasionally a trial of antibiotics is done to see if symptoms resolve prior to doing breast imaging and biopsy. Antibiotics will help an infection, but not inflammatory breast cancer. Mammography and breast ultrasound show the abnormality of inflammatory breast cancer and are used to guide a biopsy. After diagnosis, breast MRI can be performed to further evaluate the breasts and lymph nodes in the armpit. PET CT can also be performed to see if the cancer has spread to other parts of the body.
Proper diagnosis and staging of inflammatory breast cancer helps doctors develop the best treatment plan. Chemotherapy followed by surgery and radiation therapy are possible treatment options, but several factors are weighed to establish the best treatment plan for each individual patient. The most important thing for women is to know the symptoms and seek care as soon as possible. As with all cancers, the sooner diagnosed and treated, the better.