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Inflammatory Breast Cancer

Inflammatory breast cancer (IBC) is a serious kind of advanced breast cancer that accounts for between one and five percent of all breast cancer cases in the U.S.

IBC has a different phenotype, which means it looks and acts differently than other forms of breast cancer. That's because when you have IBC, you have cancer cells in the lymph vessels of your skin. Because these cells block the drainage of fluid from the skin, it makes the skin red. At diagnosis, IBC is stage III (if has spread only to the nearby lymph nodes) or stage IV (if it has spread to other organs).

Most breast cancers are detected when a lump is found through self-exam, clinical breast exam, or mammography. In contrast, the first signs of IBC are usually visual: the rapid development (within six months) of redness and warmth in the skin of the breast, often without a distinct lump. In some instances, the skin around the breast will begin to pucker or to develop dimples—somewhat like the skin of an orange—and the nipple will retract and lay flat against the breast. Swollen lymph nodes under the arm or above the collarbone are another symptom of IBC. The IBC Research Foundation's website has photographs of the breasts of women diagnosed with IBC.

Frequently the patient and even the doctor mistake IBC for a simple infection, and antibiotics are prescribed. But then the infection doesn't get better. It also doesn't get worse, and that's the tip-off: an infection always gets better or worse within a week or two—it rarely stays the same. So if you have such symptoms and they continue after antibiotic treatment, you should ask to have a biopsy done of the breast tissue and of the skin itself.

Women with IBC tend to be significantly younger than those with other breast cancers, and African Americans with this cancer tend to be younger than whites. It is also more common in women who are overweight or obese than among those who are normal weight. Most of the tumors are ER and PR negative, and many are HER2-positive.

IBC is treated first with chemotherapy to help shrink the tumor. Surgery follows chemotherapy—usually mastectomy. This is followed by radiation. Tumors that are HER2-positive can also be treated with Herceptin. If the tumor is hormone-sensitive,  either tamoxifen or an aromatase inhibitor will be added. There are also clinical trials available for women with IBC.

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