Inflammatory breast cancer (IBC) is a serious kind of advanced breast cancer. Women with IBC make up between 5 and 10 percent of all the women diagnosed with breast cancer in the United States each year. IBC has a different phenotype, which means it looks and acts differently than other forms of breast cancer.
Most breast cancers are detected when a lump is found through self-exam, clinical breast exam, or mammography. In contrast, the first signs of IBC are usually visual: The breast becomes red, swollen, and warm, and looks infected. In some instances, the skin around the breast will begin to pucker or to develop dimples—somewhat like the skin of an orange—and the nipple will retract and lay flat against the breast.
Swollen lymph nodes under the arm or above the collarbone are another symptom of IBC. Because these symptoms are similar to those of a breast infection called mastitis, it can easily be mistaken for a simple infection, and a doctor will recommend antibiotics. But it doesn't get better. It also doesn't get worse, and that's the tip-off: An infection always gets better or worse within a week or two—it rarely stays the same.
If there's no change, and the symptoms continue after treatment, you should ask to have a biopsy done of the breast tissue and of the skin itself to see if cancer cells are present. Because mastitis is much more common than IBC, this remains the best approach. It would not make sense to biopsy all women who have a red breast or swollen lymph nodes.
With IBC, you have cancer cells in the lymph vessels of your skin, which is what makes the skin red; the cancer is blocking the drainage of fluid from the skin. IBC can spread rapidly from the breast to the lymph nodes and it quickly metastasizes (spreads to other parts of the body). In fact, because IBC is so aggressive, it usually has metastasized by the time it has been diagnosed. Treatment for IBC begins with chemotherapy, which is followed by surgery and radiation. Even with the best treatment, only 47 percent of women with IBC are alive and have no sign of the disease five years after their diagnosis. Generally, if this type of cancer does not recur in five years, the woman has a good chance of being cured.
As with all advanced cancers, treatment begins with three or four cycles of AC—the A stands for doxorubicin (brand name Adriamycin) and the C stands for cyclophosphamide (brand name Cytoxan)—followed by paclitaxel (brand name Taxol) or docetaxel (brand name Taxotere). Surgery follows chemotherapy—usually mastectomy followed by radiation. If the tumor is sensitive to hormones, then either tamoxifen or an aromatase inhibitor will be used.
More is continually being learned about IBC. Researchers at the University of Michigan have discovered a gene, RhoC GTPase, that is linked to IBC, a finding that may ultimately lead to new forms of treatment for IBC. In addition, Dr. Sanford Barsky has developed an animal model of IBC, which will also help advance scientific understanding of this rare form of breast cancer.
Statistics - Inflammatory breast cancer comprises 1 to 6 percent of all breast cancers.
- Inflammatory breast cancer occurs at a younger age than noninflammatory breast cancers.
- It has been estimated that 20 percent of all deaths attributable to breast cancer are caused by IBC.
- African American women have a higher incidence of IBC than do Caucasians and other ethnic groups.
Statistics from Inflammatory Breast Cancer Research Foundation.
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