- What is inflammatory breast cancer (IBC)?
Inflammatory breast cancer is a rare but very aggressive type of breast
cancer in which the cancer cells
block the lymph
vessels in the skin of the breast. This type of breast cancer is called
“inflammatory” because the breast often looks swollen and red,
or “inflamed.” IBC accounts for 1 to 5 percent of all breast cancer
cases in the United States (1). It tends to be diagnosed
in younger women compared to non-IBC breast cancer. It occurs more frequently
and at a younger age in African Americans than in Whites. Like other types
of breast cancer, IBC can occur in men, but usually at an older age than in
women. Some studies have shown an association between family
history of breast cancer and IBC, but more studies are needed to draw
firm conclusions (2).
- What are the symptoms of IBC?
Symptoms of IBC may include redness, swelling, and warmth in the breast,
often without a distinct lump in the breast. The redness and warmth are caused
by cancer cells blocking the lymph vessels in the skin. The skin of the breast
may also appear pink, reddish purple, or bruised. The skin may also have ridges
or appear pitted, like the skin of an orange (called peau
d'orange), which is caused by a buildup of fluid
and edema
(swelling) in the breast. Other symptoms include heaviness, burning, aching,
increase in breast size, tenderness, or a nipple
that is inverted (facing inward) (3). These symptoms usually
develop quickly—over a period of weeks or months. Swollen lymph
nodes may also be present under the arm, above the collarbone, or in both
places. However, it is important to note that these symptoms may also be signs
of other conditions such as infection,
injury, or other types of cancer (1).
- How is IBC diagnosed?
Diagnosis of IBC is based primarily on the results of a doctor's clinical
examination (1). Biopsy,
mammogram,
and breast ultrasound
are used to confirm the diagnosis. IBC is classified as either stage
IIIB or stage
IV breast cancer (2). Stage
IIIB breast cancers are locally
advanced; stage IV breast cancer is cancer that has spread to other organs.
IBC tends to grow rapidly, and the physical appearance of the breast of patients
with IBC is different from that of patients with other stage III breast cancers.
IBC is an especially aggressive, locally advanced breast cancer.
Cancer staging
describes the extent or severity of an individual's cancer. (More information
on staging is available in the National
Cancer Institute (NCI) fact sheet Staging: Questions and Answers
at http://www.cancer.gov/cancertopics/factsheet/Detection/staging
on the Internet.) Knowing a cancer's stage helps the doctor develop a treatment
plan and estimate prognosis
(the likely outcome or course of the disease; the chance of recovery or recurrence).
- How is IBC treated?
Treatment consisting of chemotherapy, targeted therapy, surgery, radiation
therapy, and hormonal
therapy is used to treat IBC. Patients may also receive supportive
care to help manage the side
effects of the cancer and its treatment. Chemotherapy (anticancer drugs)
is generally the first treatment for patients with IBC, and is called neoadjuvant
therapy. Chemotherapy is systemic
treatment, which means that it affects cells throughout the body. The
purpose of chemotherapy is to control or kill cancer cells, including those
that may have spread to other parts of the body.
After chemotherapy, patients with IBC may undergo surgery and radiation therapy
to the chest
wall. Both radiation and surgery are local treatments that affect only
cells in the tumor
and the immediately surrounding area. The purpose of surgery is to remove
the tumor from the body, while the purpose of radiation therapy is to destroy
remaining cancer cells. Surgery to remove the breast (or as much of the breast
tissue
as possible) is called a mastectomy.
Lymph
node dissection (removal of the lymph nodes in the underarm area for examination
under a microscope) is also done during this surgery.
After initial systemic and local treatment, patients with
IBC may receive additional systemic treatments to reduce the risk of recurrence
(cancer coming back). Such treatments may include additional chemotherapy,
hormonal therapy (treatment that interferes with the effects of the female
hormone estrogen,
which can promote the growth of breast cancer cells), targeted therapy (such
as trastuzumab,
also known as Herceptin®),
or all three. Trastuzumab is administered to patients whose tumors overexpress
the HER–2 tumor protein.
More information about Herceptin and the HER–2 protein is available
in the NCI fact sheet Herceptin® (Trastuzumab): Questions and Answers,
which can be found at http://www.cancer.gov/cancertopics/factsheet/therapy/herceptin
on the Internet.
Supportive care is treatment given to improve the quality
of life of patients who have a serious or life-threatening disease, such
as cancer. It prevents or treats as early as possible the symptoms of the
disease, side effects caused by treatment of the disease, and psychological,
social, and spiritual
problems related to the disease or its treatment. For example, compression
garments may be used to treat lymphedema
(swelling caused by excess fluid buildup) resulting from radiation therapy
or the removal of lymph nodes. Additionally, meeting with a social
worker, counselor, or member of the clergy
can be helpful to those who want to talk about their feelings or discuss their
concerns. A social worker can often suggest resources for help with recovery,
emotional support, financial aid, transportation, or home care.
- Are clinical trials (research studies with
people) available? Where can people get more information about clinical trials?
Yes. The NCI is sponsoring clinical trials that are designed to find new
treatments and better ways to use current treatments. Before any new treatment
can be recommended for general use, doctors conduct clinical trials to find
out whether the treatment is safe for patients and effective against the disease.
Participation in clinical trials is a treatment option for many patients with
IBC, and all patients with IBC are encouraged to consider treatment in a clinical
trial.
People interested in taking part in a clinical trial should
talk with their doctor. Information about clinical trials is available from
the NCI's Cancer
Information Service (CIS) (see below) at 1–800–4–CANCER
and in the NCI booklet Taking Part in Cancer Treatment Research Studies,
which is available at http://www.cancer.gov/publications
on the Internet . This booklet describes how research studies are carried
out and explains their possible benefits and risks. Further information about
clinical trials is available at http://www.cancer.gov/clinicaltrials
on the NCI's Web site. The Web site offers detailed information about specific
ongoing studies by linking to PDQ®,
the NCI's comprehensive cancer information database. The CIS also provides
information from PDQ.
- What is the prognosis for patients with
IBC?
Prognosis describes the likely course and outcome of a disease—that
is, the chance that a patient will recover or have a recurrence. IBC is more
likely to have metastasized
(spread to other areas of the body) at the time of diagnosis than non-IBC
cases (3). As a result, the 5-year survival
rate for patients with IBC is between 25 and 50 percent, which is significantly
lower than the survival rate for patients with non-IBC breast cancer. It is
important to keep in mind, however, that these statistics are averages based
on large numbers of patients. Statistics cannot be used to predict what will
happen to a particular patient because each person's situation is unique.
Patients are encouraged to talk to their doctors about their prognosis given
their particular situation.
- Where can a person find more information
about breast cancer and its treatment?
To learn more about IBC, other types of breast cancer, and breast health
in general, please refer to the following resources: