Inflammatory Breast Cancer
(IBC; Inflammatory Carcinoma of the Breast; Inflammatory Breast Carcinoma)
DefinitionInflammatory breast cancer (IBC) is an aggressive form of breast cancer . It is different because it grows in more of a sheet-like shape and brings changes to the skin in response to inflammation. Inflammation occurs when the body is fighting infection, injury, or irritation. The changes in the skin appear similar to other conditions like mastitis . Early diagnosis and treatment are important with IBC. The sooner it is found, the more favorable the outcome. IBC is rare in women and extremely rare in men.Breast Changes Associated With IBC
CausesCancer occurs when cells in the body divide without control or order. Eventually these uncontrolled cells form a growth or tumor. The term cancer refers to malignant growths. These growths invade nearby tissues and spread to other parts of the body. It is not clear exactly what causes these problems in the cells, but is probably a combination of genetics and environment.
Risk FactorsThe average age for women with IBC (59 years old) is lower than that of women with other breast cancers. Other factors that may increase your risk of IBC include:
- African American race
- History of flattening, crusting, or retraction of the nipple
- History of mastitis that doesn't respond to antibiotic treatment
- Family members with breast cancer
- Increased breast density
SymptomsNormally, breast cancer cells create a tumor. IBC cells develop in a sheet-like pattern so you may not feel any lumps or masses. Symptoms of IBC can occur together and develop quickly. IBC may cause:
- Rapid change in the size, shape, or feel of one breast (can occur over days or weeks)
- Discoloration of the breast; breast may appear red, purple, pink, or bruised
- Peau d'orange—an area of the breast that looks like the skin of an orange
- Thickened areas of skin
- Breast feels warm to the touch
- Changes in the nipple, such as flattening, turning in, retracting, or areola color change
- Enlarged lymph nodes under the arm or above or below the collarbone
- Breast pain
DiagnosisYour doctor will ask about your symptoms and medical history. A physical exam will also be done. Since IBC develops in a sheet-like pattern, it is hard to find by a breast exam or mammogram . Test may include:
- Biopsy (excisional or skin)—a sample of tissue is removed and examined for cancer cells
- PET scan
- CT scan
- Bone scan
- Hormone receptors
- HER2 gene—suggests an aggressive form of cancer
TreatmentTalk with your doctor about the best plan for you. Finding cancer in later stages reduces the chances of a favorable outcome. Better outcomes are achieved with a combination of therapies.Treatment may include one or more of the following:
ChemotherapyChemotherapy is the use of drugs to kill cancer cells. It may be given in many forms including pill, injection, and via an IV. The drugs travel through the body in the blood, killing mostly cancer cells. Some healthy cells are killed as well. Chemotherapy drugs for IBC may include:
SurgeryThe only surgery recommended for IBC is a modified radical mastectomy . This involves removal of the whole breast, lymph nodes under the arm, and the lining over the chest muscles under the breast.
RadiationRadiation therapy is the use of radiation to kill cancer cells. It may be necessary in cases when chemotherapy prior to surgery isn't effective. Radiation may be used to shrink cancer cells in advance of surgery. Types of radiation therapy include:
- External radiation therapy—radiation directed at the breast from a source outside the body
- Internal radiation therapy—radioactive materials placed into the breast in or near the cancer cells
OtherThere are other factors about your specific type of cancer that can affect treatment such as:
- Hormone receptors—some cancers have hormone receptors attached to them. Certain drugs can target these receptors to help control or eliminate the cancer. This hormone therapy may include drugs such as:
- Aromatase inhibitor
- HER2—Cancers with the HER2 gene tend to be more aggressive. Drugs that may be effective against HER2-positive cancer include:
PreventionIt is important to catch IBC as early as possible. If you have any of the symptoms listed above, see your doctor right away. If you are being treated for mastitis that is not responding to treatment, see your doctor again. Breast exams may help identify changes in your breast, such as the orange-peel skin. For breast exams, the American Cancer Society recommends:
- Women aged 20 or older may perform a breast self-exam (BSE) every month. Report any changes to your doctor right away.
- Women aged 20-39 should have a clinical breast exam by a health professional every three years. Starting at age 40, women should have a clinical breast exam every year.
- A breast exam should be done more regularly if there is a family history or there have been previous breast biopsies.
National Breast Cancer Foundation
National Cancer Institute
Canadian Cancer Society
Women’s Health Matters
Breast cancer in men. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.. Updated August 1, 2012. Accessed January 2, 2014.
Breast cancer in women. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.. Updated December 16, 2013. Accessed January 2, 2014.
Dawood S, Merajver SD, et al. International expert panel on inflammatory breast cancer: consensus statement for standardized diagnosis and treatment.Ann Oncol. 2011;22(3):515-523.
Inflammatory breast cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/002298-pdf.pdf. Accessed January 2, 2014.
Inflammatory breast cancer. National Breast Cancer Foundation website. http://www.nationalbreastcancer.org/inflammatory-breast-cancer. Accessed January 2, 2014.
Inflammatory breast cancer fact sheet. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Sites-Types/IBC. Updated April 18, 2012. Accessed January 2, 2014.
- Reviewer: Mohei Abouzied, MD, FACP
- Review Date: 12/2014
- Update Date: 12/20/2014