What to know about inflammatory breast cancer

A lump is the most common and widely recognized symptom of breast cancer. But in one aggressive form of breast cancer, you are more likely to notice changes in the texture or appearance of the breast.

Inflammatory breast cancer typically does not cause breast lumps, making it difficult to detect in a routine breast exam or mammogram. The condition often progresses quickly and is rare, accounting for 2% to 4% of breast cancer cases in the U.S., according to the National Library of Medicine. It also contributes to 7% of breast cancer deaths.

“Inflammatory breast cancer shows as an enlarged breast that is swollen and very red,” says Dr. Amelia Jeyapalan, a breast cancer surgeon at Advocate Health Care. “In many cases, the skin will take on a ridged or pitted appearance, similar to an orange peel. This is because the cancer cells are starting to invade the dermal lymphatics, a vessel that lies below the skin.”

When doctors approach any breast cancer treatment, understanding the biology of the tumor is the first place they should start, Dr. Jeyapalan says.

Various factors are considered when evaluating treatment options, including:

• How fast is the cancer growing?
• Does the cancer look and act like normal breast tissue with estrogen and progesterone receptors? Doctors may be able to provide a medication that blocks these hormones in the breast tissue to help kill the cancer.
• What is the growth factor receptor? Some breast cancers develop a receptor called HER-2, which binds to the growth factors in the brain or heart muscles. This may affect the course of treatment.

“Any tumor biology can present as inflammatory breast cancer,” Dr. Jeyapalan says. “These cancers are more aggressive and tend to metastasize or spread to other parts of the body.”

For most patients diagnosed with inflammatory breast cancer, treatment typically starts with chemotherapy, she says.

The next step is usually surgery to remove the breast and the axillary nodes, or the lymph nodes in the underarm, which is typically the first place breast cancer will spread. Radiation to the chest wall is the last step in the treatment process.

“It is rare to see full recovery from this cancer, usually due to it spreading prior to being found,” Dr. Jeyapalan says. “Although, individuals all respond to treatment differently, where some respond positively and have a complete recovery.”

Want to learn more about your risk for breast cancer? Take this free online quiz.