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Inflammatory breast cancer (IBC) is a rare and aggressive malignancy that accounts for only a small percentage of breast cancer cases. Although it is not related to inflammation, the condition is called “inflammatory” because its primary feature is the rapid and often dramatic onset of symptoms that are similar to those of inflammation or infection of the breast tissue. IBC is unique in that unlike most other types of breast cancer, it does not typically produce a noticeable lump or mass that can be felt during a breast self-examination or seen in a mammogram.

In most cases, inflammatory breast cancer originates in the milk duct cells and spreads to the lymphatic vessels in the breast skin. This type of IBC is known as invasive ductal carcinoma.

Inflammatory breast cancer causes and risk factors 

The exact cause of inflammatory breast cancer is not well understood. Scientists believe it most likely results from a complex mix of genetic, environmental and lifestyle factors. Unlike some other types of breast cancer, IBC does not have well-defined risk factors that are consistently associated with its development. Some possible risk factors include:

  • A genetic predisposition - IBC runs in some families with a history of breast cancer or specific gene mutations, such as breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2) mutations.
  • Age and gender - Compared to other types of breast cancer, IBC is more frequently diagnosed in young women and is exceedingly rare in males.
  • Race and ethnicity - Some studies suggest that IBC may be more common in certain populations, such as African-American women.
  • Lifestyle practices - Certain characteristics and behaviors, such as obesity and smoking, are known risk factors for breast cancer in general.

It is important to keep in mind that inflammatory breast cancer is an uncommon malignancy, and having one or more risk factors does not mean a diagnosis is inevitable. Likewise, IBC occurs in some people who have no known risk factors.

Inflammatory breast cancer signs and symptoms 

Inflammatory breast cancer is characterized by its specific and rapidly developing symptoms, which often appear within a few weeks or even days. Common signs include:

  • Breast skin changes - As cancer cells block the lymph nodes in the breast skin, the skin may become thickened, dimpled or pitted, taking on the appearance and texture of an orange peel (peau d’orange).
  • Breast redness and warmth - The breast may become swollen, warm and reddened,  similar to a sunburn.
  • Nipple changes - The nipple may turn inward (invert) or flatten.
  • Breast pain - The breast may feel tender, heavy or itchy.
  • Unusual nipple discharge - Clear or bloody discharge may leak from the nipple.
  • Swollen lymph nodes - Enlarged lymph nodes may be felt around the collarbone or in the underarm (axillary) area or neck.
  • Unexplained fatigue or weight loss - Fatigue and weight loss are associated with many types of cancer, particularly in advanced stages.

Because inflammatory breast cancer symptoms can progress quickly and mimic those of a breast infection, such as mastitis, it is important to promptly discuss any unusual changes with a physician. Like all cancers, the early detection and prompt treatment of inflammatory breast cancer are essential to ensure the best possible outcome and quality of life.

Inflammatory breast cancer diagnosis

The diagnostic process for inflammatory breast cancer typically involves a clinical evaluation, imaging tests and a definitive tissue biopsy to confirm the presence of cancer. Here is an overview of the steps:

  • Clinical evaluation - A physician will take a detailed medical history and perform a thorough physical examination, specifically looking for the characteristic symptoms of IBC, such as peau d’orange.
  • Imaging - Common imaging techniques used to evaluate IBC include mammography, breast ultrasound, breast magnetic resonance imaging (MRI) and chest X-rays.
  • Biopsy - A physician will use a thin needle to remove a small sample of suspicious breast tissue for examination by a pathologist, who will view the sample under a microscope to check for cancerous cells.

Inflammatory breast cancer treatment

IBC treatment is typically aggressive and may involve a combination of therapies to effectively control and manage the cancer. The choice of treatment can vary depending on several factors, including the stage of the cancer and the patient's overall health. A treatment plan may include:

  • Chemotherapy before surgery - Chemotherapy is often the first step in treating IBC. The goal is to reduce the size of the tumor and increase the likelihood of successful surgical removal.
  • Surgery- After an initial course of chemotherapy, surgery is usually performed to remove the remaining cancer and affected lymph nodes. The surgical procedure may be a modified radical mastectomy, which involves the removal of the entire breast, underlying chest wall muscles and lymph nodes. Breast-conserving surgery (lumpectomy) is generally not recommended for IBC due to the extensive nature of the disease.
  • Radiation therapy - Following surgery, radiation therapy may be administered to the chest wall and regional lymph nodes to target any remaining cancer cells and reduce the risk of recurrence.
  • Additional chemotherapy - Chemotherapy may be given after surgery and radiation therapy to address any remaining cancer cells and further reduce the risk of cancer recurrence.
  • Targeted therapy - Some patients with HER2-positive IBC may benefit from therapies that target specific molecules or pathways that signal the cancer cells to grow and divide.
  • Hormone therapy - In cases of hormone receptor-positive IBC, hormone therapy (such as tamoxifen or aromatase inhibitors) may be recommended to block the effects of estrogen on cancer cells.

Frequently asked questions (FAQs) about inflammatory breast cancer

Because each patient is unique, the best source of personalized information about inflammatory breast cancer is a physician who is familiar with the case. However, if you have general questions or are learning about this rare malignancy for the first time, you might it helpful to review the answers to the following FAQs:

Benefit from world-class care at Moffitt Cancer Center

Moffitt’s Don & Erika Wallace Comprehensive Breast Program features a multispecialty team trained specifically in the evaluation and treatment of all types of breast cancer, including inflammatory breast cancer. Our comprehensive, patient-centered approach sets us apart in many ways. For instance:

  • We provide our patients with comprehensive healthcare services for all types of breast cancer in one place, including everything from screening and diagnostic tests to the latest treatment options and clinical trials.
  • Our patients and their families have access to an extensive range of supportive care services, including family counseling, massage therapy, yoga and nutrition planning.
  • Because our specialists work closely together to discuss and evaluate complex cases at regular tumor board reviews, our treatment plans and schedules are highly precise and individualized, which can improve survival rates and cosmetic outcomes and minimize the need for secondary surgeries and follow-up treatments.
  • We support our patients for life by offering various wellness and supportive care programs.

As a National Cancer Institute-designated Comprehensive Cancer Center, Moffitt is widely known and respected for its trailblazing research initiatives. Our clinicians and researchers work closely together, regularly investigating new therapy options to implement in breast cancer clinical trials. Through these and other efforts, we continue to improve cancer survival rates and provide each patient with the best possible quality of life.

If you have questions about inflammatory breast cancer, you can request an appointment with an expert at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. You do not need a referral.