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INFLAMMATORY BREAST CANCER

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Written by : Dr.M.D.Mazumdar, MD

Inflammatory Breast Cancer (IBC) is a rare type of breast cancer. It constitutes only about 1-5% of all breast cancer cases. But it is a particularly aggressive form of cancer and can spread within days of being diagnosed.

Inflammatory Breast Cancer occurs in somewhat younger women as compared to other types of breast cancer like ductal breast cancer or lobular breast cancer. The average age is around 55-57 years of age. In some women, IBC can occur in quite a young age - the first symptoms may even appear during pregnancy or lactation and may get ignored.

Risks of getting inflammatory breast cancer increases in overweight women. And like all other types of breast cancers, it can also occur in men, especially in overweight men.

Inflammatory Breast Cancer usually grows in nests or sheets, rather than as a confined, solid tumor. So it can be present throughout the breast with no palpable mass and no other symptoms of breast cancer before it is diagnosed. Delay in diagnosis also occurs because it is often confused with simple inflammatory conditions like mastitis (infection of the breast). If symptoms of mastitis persist after a week of treatment with antibiotics, it is always advisable to get a biopsy.

Scientists have now identified a key gene -- eIF4G1 -- that is overexpressed in the majority of cases of IBC, allowing cells to form highly mobile clusters that are responsible for the rapid metastasis that makes IBC such an aggressive and deadly cancer.

Inflammatory Breast Cancer
INFLAMMATORY BREAST CANCER

Symptoms of Inflammatory Breast Cancer (IBC):

As already noted, the symptoms of Inflammatory breast cancer are very similar to Mastitis. And very often it may be mistaken for this condition. And it has to be emphasized that any mastitis which does not respond to antibiotics and anti-inflammatory medicines after 1 week of treatment needs to be investigated for inflammatory breast cancer.

  • No lump: There is no definite lump or mass felt in Inflammatory breast cancer.

  • Redness of the Breast: In most cases, IBC can start with a diffuse redness of the breast without any identifiable cause for the apparent inflammation. The redness may start on one side and spread quickly, sometimes within hours.

  • Breast feels Warm : The breast feels warm to the touch as compared to the skin on other parts of the body due to the acute inflammatory reaction.

  • Increase in Size of the Breast : The breast may increase suddenly in size over a relatively short period of time - sometimes a cup size in a few days. The breast may feel heavy, hard and uncomfortable. The enlargement may caused by cancer cells blocking the lymph vessels in the skin and causing congestion.

  • Severe Itching : There may be severe itching all over the breast, contributing to the redness and thickening of the skin. Very often, IBC is diagnosed only after the itching has not gone down with any anti-itch medicines, including anti-fungal medicine.

  • Thickening of the Skin of the Breast : There may be ridges and thickened areas of the skin. The skin may appear pitted, like the skin of an orange (called peau d'orange) - this is caused by a buildup of fluid and edema (swelling) in the breast, also a result of blockage of the lymph vessels. The skin of the breast might look pink or bruised, and what looks like ridges, welts, or hives may be seen on the breast.

  • Nipple Discharge: Some women may have a nipple discharge which may be yellowish, greenish or reddish. Reddish implies the presence of blood while greenish or yellowish may indicate the presence of infection.

  • Pain in the Breast: Breast pain which is constant or stabbing in nature may occur. The time of occurance of the pain is not related to the menstrual cycle. Breasts which have a constant deep aching or burning sensation should be investigated for inflammatory breast cancer.

  • Nipple Changes: The nipple may go flat or turn inward (inversion). There may be change in the color and/or texture of the areola (pigmented area surrounding the nipple).

  • Lymph Node Enlargement: Some women may present with enlarged lymph nodes of the armpit or the neck region, as a first symptom of inflammatory breast cancer. But in most women, it is a later sign.

  • Swelling of the Arm: Rapid spread of cancer cells to the lymph nodes of the arm can cause blockage of the lymphatic channels of that arm. The arm may thus swell up and in rare cases, a swollen arm may be the first symptom of inflammatory breast cancer.

    See Page 2 for:

  • Stages of Inflammatory Breast cancer
  • Diagnosis of Inflammatory Breast cancer
  • Treatment of Inflammatory Breast cancer



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