Inflammatory breast cancer (IBC) is an aggressive form of
. It is different because it grows in more of a sheet-like shape and brings changes to the skin in response to inflammation. Inflammation occurs when the body is fighting infection, injury, or irritation. The changes in the skin appear similar to other conditions like
. Early diagnosis and treatment are important with IBC. The sooner it is found, the more favorable the outcome.
IBC is rare in women and extremely rare in men.
Breast Changes Associated With IBC
Skin changes that resemble the skin of an orange and/or inversion of the nipple may be signs of IBC.
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Cancer occurs when cells in the body divide without control or order. Eventually these uncontrolled cells form a growth or tumor. The term cancer refers to malignant growths. These growths invade nearby tissues and spread to other parts of the body. It is not clear exactly what causes these problems in the cells, but is probably a combination of genetics and environment.
The average age for women with IBC (59 years old) is lower than that of women with other breast cancers. Other factors that may increase your risk of IBC include: African American raceObesityHistory of flattening, crusting, or retraction of the nipple
that doesn't respond to antibiotic treatment
Family members with breast cancerIncreased breast density
Studies show that most women with known risk factors do not get breast cancer. Many women who get breast cancer have none of the risk factors listed above.
Normally, breast cancer cells create a tumor. IBC cells develop in a sheet-like pattern so you may not feel any lumps or masses. Symptoms of IBC can occur together and develop quickly. IBC may cause: Rapid change in the size, shape, or feel of one breast (can occur over days or weeks)Discoloration of the breast; breast may appear red, purple, pink, or bruisedPeau d'orange—an area of the breast that looks like the skin of an orangeThickened areas of skinBreast feels warm to the touchChanges in the nipple, such as flattening, turning in, retracting, or areola color changeEnlarged lymph nodes under the arm or above or below the collarboneItchingBreast pain
Some of these symptoms are similar to a condition known as
mastitis. However, mastitis should respond to
treatment. If it does not, talk to your doctor again right away.
Your doctor will ask about your symptoms and medical history. A physical exam will also be done. Since IBC develops in a sheet-like pattern, it is hard to find by a breast exam or
Test may include: Biopsy
(excisional or skin)—a sample of tissue is removed and examined for cancer cells
PET scanCT scanBone scan
If cancer is detected, the cancerous tissue will also be tested to look for: Hormone receptorsHER2 gene—suggests an aggressive form of cancer
The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. IBC is generally detected in later stages, which gives cancer cells more time to invade other tissues.
Talk with your doctor about the best plan for you. Finding cancer in later stages reduces the chances of a favorable outcome. Better outcomes are achieved with a combination of therapies.
Treatment may include one or more of the following:
is the use of drugs to kill cancer cells. It may be given in many forms including pill, injection, and via an IV. The drugs travel through the body in the blood, killing mostly cancer cells. Some healthy cells are killed as well. Chemotherapy drugs for IBC may include:
The only surgery recommended for IBC is a modified radical
. This involves removal of the whole breast, lymph nodes under the arm, and the lining over the chest muscles under the breast.
is the use of radiation to kill cancer cells. It may be necessary in cases when chemotherapy prior to surgery isn't effective. Radiation may be used to shrink cancer cells in advance of surgery. Types of radiation therapy include:
External radiation therapy—radiation directed at the breast from a source outside the bodyInternal radiation therapy—radioactive materials placed into the breast in or near the cancer cells
There are other factors about your specific type of cancer that can affect treatment such as:
Hormone receptors—some cancers have hormone receptors attached to them. Certain drugs can target these receptors to help control or eliminate the cancer. This hormone therapy may include drugs such as:
HER2—Cancers with the HER2 gene tend to be more aggressive. Drugs that may be effective against HER2-positive cancer include:
It is important to catch IBC as early as possible. If you have any of the symptoms listed above, see your doctor right away. If you are being treated for mastitis that is not responding to treatment, see your doctor again.
Breast exams may help identify changes in your breast, such as the orange-peel skin. For breast exams, the
American Cancer Society
Women aged 20 or older may perform a
(BSE) every month. Report any changes to your doctor right away.
Women aged 20-39 should have a clinical breast exam by a health professional every three years. Starting at age 40, women should have a clinical breast exam every year.
A breast exam should be done more regularly if there is a family history or there have been previous breast biopsies.
Breast cancer in men. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.. Updated August 1, 2012. Accessed January 2, 2014.
Breast cancer in women. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.. Updated December 16, 2013. Accessed January 2, 2014.
Dawood S, Merajver SD, et al. International expert panel on inflammatory breast cancer: consensus statement for standardized diagnosis and treatment.
Ann Oncol. 2011;22(3):515-523.
Inflammatory breast cancer. American Cancer Society website. Available at:
http://www.cancer.org/acs/groups/cid/documents/webcontent/002298-pdf.pdf. Accessed January 2, 2014.
Inflammatory breast cancer. National Breast Cancer Foundation website.
http://www.nationalbreastcancer.org/inflammatory-breast-cancer. Accessed January 2, 2014.
Inflammatory breast cancer fact sheet. National Cancer Institute website. Available at:
http://www.cancer.gov/cancertopics/factsheet/Sites-Types/IBC. Updated April 18, 2012. Accessed January 2, 2014.
Last reviewed December 2014 by Mohei Abouzied, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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