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 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
- A 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.
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.
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.