Breast Cancer - Inflammatory Breast Cancer (IBC)

There are many types of breast cancer and not all look the same way. Not all breast cancers show up as a lump. One type of breast cancer that does not typically present as a lump is Inflammatory Breast Cancer or IBC. IBC makes up only 1% to 6% of all breast cancers, so many people are not familiar with the disease.

IBC is the most aggressive type of breast cancer. It tends to grow at a much faster rate than the other types of cancer. IBC grows in sheets or nests of cells in the breast as opposed to growing in a solid tumor. IBC grows in the dermal (skin) lymphatic system which explains why there is usually no lump associated with it. The symptoms of IBC appear due to the cancer cells blocking the lymph vessels below the skin - typically presenting as warm skin and color changes. Because of the involvement of the lymphatic system, IBC carries an initial Stage 3 diagnosis, however, the earlier you detect the disease and begin treatment, the greater your chances of survival.

Symptoms of IBC include a rapid, unusual increase in breast size; nipple discharge or change in the areola area (the pigmented area around the nipple); any skin changes of the breast such as redness, rash or blotchiness; a flattening or retracting of the nipple; persistent itching of the breast or nipple; dimpling or ridging of the nipple; a lump or thickening of the breast tissue; any lymph node swelling under the arm or above the collar bone; stabbing pain or sore breast; and a feverish breast. These symptoms may appear quickly and seemingly out of nowhere. Mammograms and ultrasounds usually miss IBC unless there is a tumor involved.

IBC can be detected by a number of biopsy methods. A skin punch biopsy or needle core biopsy in combination with an MRI and/or a PET scan are usually the course of action when investigating suspicious symptoms. Any area of concern removed by biopsy must also include the tissue from below the skin surface. Another term used to refer to IBC in a pathology report is "dermal lymphatic involvement".

Some doctors will treat women with an antibiotic for mastitis upon initial consultation. Mastitis is a benign breast infection. If your symptoms have not improved after 7-10 days of antibiotic treatment, insist on a biopsy. Some skin rashes can be caused by allergies or are reactions to certain soaps and/or detergents. Changing the soap or detergent you use can sometime resolve a skin rash, but if there is no improvement you should insist on a biopsy.

One myth of breast cancer is that is does not hurt. Most of the time breast pain comes from non-cancer causes, such as hormonal changes. With IBC there is pain involved more so than other types of breast cancer.

The treatment for IBC includes chemotherapy, modified radical mastectomy (MRM) and auxiliary lymph node dissection (ALND) and radiation. If the cancer is hormone receptive, a hormonal treatment like Tamoxifen is used.

As with all breast cancer symptoms, any indication of IBC should not be taken lightly. Chances are in your favor that it will be benign, but in the event that you do have IBC, early detection and treatment are key to your survival.

Michael Russell

Your Independent guide to Breast Cancer