Fact or Fiction: Symptoms of Inflammatory Breast Cancer

Inflammatory breast cancer (IBC) is a rare but aggressive form of breast cancer that affects young women more than older women.  Because it’s relatively uncommon — it represents less than five percent of all breast cancer cases — people are often confused about what inflammatory breast cancer is and how you can detect it.

As a breast oncologist specializing in inflammatory breast cancer, I want to share some of the common myths to help you separate fact from fiction about IBC.

Dr. Beth Overmoyer, director of the Inflammatory Breast Cancer Program at Dana-Farber Cancer Institute

If there’s no lump, there’s no cancer.
Fiction. Unlike other types of breast cancer, which are detected with a mass or lump in the breast, IBC may be detected without a lump. Symptoms of inflammatory breast cancer can include

  • Pain or itchiness of the breast
  • Redness of the breast
  • Swelling or enlargement of the breast
  • Swelling of the lymph nodes in the armpit or above/below the collarbone
  • Thickening of the skin of the breast or ridged or dimpled skin texture (sometimes called peau d’orange, because it looks like the skin of an orange)

IBC is often misdiagnosed as an infection.
Fact. Many of the symptoms of inflammatory breast cancer are similar to the symptoms of an infection called mastitis. This similarity can complicate the diagnosis. Mastitis is treated with antibiotics, but if symptoms don’t improve after a few days on antibiotics, you should talk to an oncologist who specializes in IBC.

There are effective treatments for inflammatory breast cancer.
Fact. As with many cancers, early detection is important to effective treatment. If you are concerned that you may have symptoms, don’t wait. See your doctor.

Because inflammatory breast cancer involves the breast as well as the blood stream, the primary treatment is chemotherapy. There are some targeted therapies — angiogenesis drugs that target the blood vessels that cancers need to grow, and Herceptin, which targets the HER2 subtype of breast cancer, for example — that have been very effective in treating IBC.

After we get the maximum effect from chemotherapy, the next step is surgery. Unfortunately, IBC is a cancer that involves the entire breast. It doesn’t just show up as a lump in one part of the breast but involves the lymphatics, which are channels that run around and through the breast. So the surgery that we need to do is a mastectomy. We then follow up with radiation to take care of any residual cancer that may be in the chest wall or in the lymph node groups.

This combination of treatment — chemotherapy, mastectomy and radiation therapy — has significantly improved survival, but more work is needed to understand this disease.

If I have a mastectomy as part of my treatment for IBC, I can’t have breast reconstruction.
Fiction. While we recommend that patients wait for six to twelve months before they have breast reconstruction, it is an option for women who have had inflammatory breast cancer.

Because IBC is rare, there is not a lot of focus on research.
Fiction. There is a great deal of research underway. Last year, I was awarded a grant from the Inflammatory Breast Cancer Research Foundation to study IBC. We are working on a new clinical trial specifically targeting IBC and one of the important pathways that stimulates cancer growth. In addition, we have a clinical trial for newly diagnosed IBC which includes one of the important new drugs targeting HER2. Our clinical trials for IBC always include a scientific component in order to improve our understanding of this virulent disease.

Dr. Beth Overmoyer is a physician at Dana-Farber Cancer Institute and director of the Inflammatory Breast Cancer Program.