Inflammatory Breast Cancer

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KEY POINTS

• Inflammatory breast cancer is a growth of abnormal cells in the lymph vessels in the skin of the breast. It is called inflammatory because the breast often looks red and swollen.
• Treatment includes medicine such as chemotherapy, hormone therapy, or biologic therapy. It also includes radiation therapy or surgery.
• Talk with your healthcare provider about ways to best care for yourself during treatment.

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What is inflammatory breast cancer?

Inflammatory breast cancer (IBC) is a growth of abnormal cells in the lymph vessels in the skin of the breast. The lymph system is part of your body's system for fighting infection. The lymph system consists of lymph nodes that store blood cells (lymphocytes) to fight infection and vessels that carry fluid, nutrients, and wastes between your body and your bloodstream.

This is a rare form of breast cancer. It is called inflammatory because the breast looks red and swollen.

The sooner cancer is found and treated, the better your chances for recovery. However, even advanced cancer can usually be treated. Treatment may slow or stop the growth of the cancer and ease symptoms for a time. Ask your healthcare provider what you can expect with the type of cancer that you have.

What is the cause?

The exact cause of IBC is not known. You may have a higher risk if:

• You had breast cancer or some non-cancerous breast diseases
• You have a family history of breast or ovarian cancer (especially mother, sister, or daughter, but also from other relatives on either your father’s or mother’s side)
• You have genetic changes (mutations) in certain genes (BRCA1 and BRCA2)
• You had radiation therapy to the chest
• You drink alcohol (risk rises as intake increases)
• You are overweight or obese
• You do not get regular exercise
• You had your first period before the age of 12
• You never gave birth
• You were older at the birth of your first child
• You did not breast-feed
• You are African American

What are the symptoms?

Unlike other kinds of breast cancer, IBC does not cause a lump in your breast. Symptoms may include:

• Red, bruised, or swollen skin in some part of your breast, under your arm, or near your collarbone
• Dimpled or pitted skin on your breast that looks like the skin of an orange
• Thickened or ridged skin on one breast
• Rapid increase in the size of your breast
• Feeling of heat, tenderness, or heaviness in your breast
• Change in nipple shape or appearance

What is metastasis?

IBC is very fast growing, and spreads quickly to other parts of the body. The spread of cancer cells from one part of the body to other parts is called metastasis. What causes cancer to spread is not known. Cancer cells can:

• Grow into the area near the cancer
• Travel to other parts of the body through the bloodstream or the lymph system. The lymph system is part of your body's system for fighting infection. The lymph system consists of lymph nodes that store blood cells (lymphocytes) to fight infection and vessels that carry fluid, nutrients, and wastes between your body and your bloodstream.

New tumors then grow in these other areas. When breast cancer spreads, it is most often found in the bones of the pelvis, spine, upper arms and legs, ribs, and skull. Tumors are also commonly found in the liver, lungs, and brain.

Sometimes your first symptoms of cancer are in the part of the body where the cancer has spread. The symptoms of IBC that has spread to another part of your body depend on where the tumors are. For example:

• If the cancer has spread to the lungs, you may have a cough or trouble breathing.
• If the cancer has spread to the liver, you may have yellowish skin, pain, or swelling in your belly.
• If the cancer has spread to the bones, you may have pain or your bones may break easily.
• If the cancer has spread to the brain, you may have trouble thinking, speaking, or walking.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may have tests such as:

• Mammogram, which is an X-ray of the breast to look for cancer or to check a lump felt in the breast
• Ultrasound, which uses sound waves to show pictures of the breast tissue
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the breast tissue
• Breast biopsy, which is the removal of a small sample of tissue for testing. The tissue is examined for the presence of cancer.

You may have X-rays or other tests to see if cancer has spread to other parts of your body.

How is it treated?

You and your healthcare provider will discuss possible treatments. You may also talk with a surgeon, medical oncologist, and radiation oncologist. Oncologists are cancer specialists.

Some things to think about when making treatment decisions are:

• Your age
• The stage of the cancer (how advanced the cancer is)
• The effect of hormones on the cancer
• The type of breast cancer
• Whether the cancer has spread to lymph nodes or other parts of your body

Possible treatments are:

• Mastectomy to remove the breast and most or all of the lymph nodes under your arm
• Radiation therapy, which uses high-energy X-rays to kill cancer cells
• Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells
• Hormone therapy, which uses medicine to stop hormones in your body from helping tumors grow
• Biological therapy, which uses medicine designed to help your immune system fight the cancer or block the growth of cancer cells

Often, more than 1 type of treatment is used.

If you are going to have surgery to remove your breast, talk to your healthcare provider about the options for breast reconstruction.

How can I take care of myself?

If you have been diagnosed with IBC:

• Talk about your cancer and treatment options with your healthcare provider. Make sure you understand your choices.
• Follow the full course of treatment prescribed by your healthcare provider.
• Ask your healthcare provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

Other things that may help include:

• Eat a healthy diet and get regular exercise as recommended by your healthcare provider.
• Get plenty of rest.
• Ask your provider if you need to avoid drinking alcohol. It may interfere with medicines you are taking. Alcohol can also make it harder for white blood cells to fight infections.
• Try to reduce stress and take time for activities that you enjoy. It may help to talk with a counselor about your illness.
• Talk with your family and your healthcare providers about your concerns. Ask your healthcare provider any questions you have about the disease, treatments, side effects of the treatments, sexual activity, support groups, and anything else that concerns you.
• Tell your provider if your treatment causes discomfort. Usually there are ways to help you be more comfortable.

There are many support services for women with breast cancer. You can find the names of groups and agencies from your healthcare provider or through your local American Cancer Society office.

For more information, contact:

• American Cancer Society, Inc.
  800-227-2345
  http://www.cancer.org
• National Cancer Institute
  800-422-6237 (TTY: 800-332-8615)
  https://www.cancer.gov/