Inflammatory Breast Cancer

Inflammatory breast cancer (IBC) is an aggressive, invasive breast cancer. It is very rare, making up less than 5% of all breast cancers diagnosed. Houston Methodist’s breast cancer specialists have the experience to diagnose and treat IBC quickly, so you can move on to treatment with confidence.

What Is Inflammatory Breast Cancer?

Most types of breast cancer manifest as lumps made up of cancer cells. With inflammatory breast cancer, there is often no lump. Instead, cancer cells block the lymph vessels around the breast. This causes the breast to swell, redden or develop a thickened, pitted texture known as “orange peel” skin, or “peau d’orange.”

IBC grows and spreads faster than other breast cancer types. It also tends to affect a younger age group, mostly diagnosed in people ages 40 and younger. IBC is considered a form of invasive breast cancer that starts in the breasts’ milk ducts, but it behaves and spreads differently, creating distinctions in both symptoms and treatments.

Signs and Symptoms of Inflammatory Breast Cancer

IBC often looks and feels different from other breast cancers, especially as it typically does not lead to a lump in the breast, which is one of the most well-known signs of breast cancer. Instead, many of the symptoms of inflammatory breast cancer are sensations and changes to how the breast looks. Signs of inflammatory breast cancer can appear as external changes in the breast, including:

Breast Swelling and Rapid Changes

With IBC, the breast can change noticeably in a short period of time, often only a few weeks. Breast swelling, warmth and tenderness are common early signs.

Orange Peel Skin

Sometimes referred to as peau d’orange, this happens when the skin of the breast starts to dimple or pit, giving it a texture that looks like an orange peel.

Swollen Lymph Nodes

Lymph nodes under the arm or near the collarbone can swell as cancer cells travel through the lymphatic system. Swollen lymph nodes can also feel hard and tender.

Nipple Changes

In cases of IBC, the nipple may begin to turn inward. This is called an inverted or retracted nipple.

 

Inflammatory breast cancer can look like a breast infection at first. Breast infections like mastitis are far more common than IBC, but if symptoms don’t clear up with antibiotics, it’s important to see a breast surgeon for closer examination.

How Is Inflammatory Breast Cancer Diagnosed?

If inflammatory breast cancer is suspected, your doctor may complete several tests to rule out or diagnose it, including: 

Physical Exam 

A provider will look at your breast for any changes that may indicate inflammatory breast cancer and rule out any other conditions that could cause breast inflammation, such as mastitis. 

Mammogram and Other Imaging

A mammogram is often the next step after a physical exam. A breast ultrasound may follow, depending on the results. It’s important to keep in mind that both can be hard to read for IBC since there’s often no distinct mass.

Biopsy

Biopsy is the most reliable way to confirm an IBC diagnosis. There are two types of biopsies used to diagnose inflammatory breast cancer: breast biopsy and skin punch biopsy. A breast biopsy takes a sample of breast tissue, whereas the skin punch biopsy will take a sample of breast skin.

If inflammatory breast cancer is diagnosed, molecular testing will be used to check for hormone receptor-positive status (estrogen or progesterone receptors) and the HER2 protein. This will guide your care team in determining your treatment plan.

Staging

If inflammatory breast cancer is confirmed, your doctor may order a CT scan, PET scan or bone scan to check whether the cancer has spread or metastasized outside of the breast. Because IBC involves the skin of the breast, it is often at stage III (locally advanced) or stage IV (metastatic breast cancer) at diagnosis.

Who Is Most at Risk of Inflammatory Breast Cancer?

Risk factors for inflammatory breast cancer can include: 

 

  • Age: This type of breast cancer typically  affects women age 40 and younger
  • Gender: Women are more affected by this type of cancer than men, although both genders can develop the condition. 
  • Race: women are more at risk than women of other races.
  • Weight: Being overweight or experiencing obesity can increase the risk of being diagnosed with this type of breast cancer. 
 
No matter your risk level, early detection is crucial. Talk to your doctor as soon as you notice any changes in your breast.

Treatment Options

Inflammatory breast cancer is aggressive and treatment plans usually include chemotherapy, surgery and radiation.

Chemotherapy

Chemotherapy, also called chemo, is a type of medication used to destroy cancer cells. Chemotherapy can be administered via an IV or as a pill. Chemotherapy may be used to shrink cells before surgery (called neoadjuvant chemotherapy), so the cancer is easier to remove during surgery. It may also be used to kill any cells that remain after surgery.

Mastectomy

Mastectomy surgery removes the entire breast affected by the condition. The lymph nodes may also be removed. Given the nature of inflammatory breast cancer, breast-conserving procedures, such as lumpectomies, often aren’t possible. Breast reconstruction may be an option for many mastectomy patients.

Radiation

Radiation therapy, which uses powerful X-ray technology, is often used after surgery to target any cancer cells that may remain.

Targeted Therapy

Targeted therapy attacks specific features of cancer cells. If your cancer carries the HER2 protein, your care team may add a targeted drug like trastuzumab, often paired with chemo before or after surgery along with hormone therapy.

Hormone Therapy

If molecular testing uncovers that the cancer cells contain estrogen or progesterone receptors, hormone therapy can be used to help block these hormones from assisting cancer growth. Such medications, like tamoxifen or aromatase inhibitors, may help prevent the spread of cancer to other parts of the body or may be used after surgery to keep cancer from recurring.

Immunotherapy

This type of treatment helps your immune system find and target cancer. Immunotherapy may be an option for inflammatory breast cancer if it is triple-negative, meaning cancer cells do not contain HER2 or hormone receptors.

Why Choose Houston Methodist as Your Cancer Care Provider

Houston Methodist has been named the No.1 hospital in Texas by U.S. News & World Report for 15 years running. Houston Methodist Neal Cancer Center houses our medical oncology and surgical oncology teams, where innovation meets personalized treatment. We offer compassionate, expert cancer care that aligns with National Cancer Institute treatment guidelines and brings you the latest options in IBC care.

At Houston Methodist, you're not just a patient. You're part of a family united in the fight against breast cancer. You can trust our team to provide top-tier medical care and unwavering support every step of the way.

FAQs: Inflammatory Breast Cancer

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