Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer that occurs when malignant cells block the skin and lymph vessels of the breast. IBC is different from other forms of breast cancer because it may not cause a lump or tumor.
This cancer accounts for only 1 to 5 percent of all cases of breast cancer, and it has a five-year survival rate of only 40 percent. So it's important to recognize the signs of inflammatory breast cancer and speak with a doctor immediately if you notice changes in your breast.
Because IBC is an aggressive form of cancer, the disease can progress rapidly within days, weeks, or months. Because of this, there aren’t any early-stage symptoms. You might not develop a lump that’s characteristic of other breast cancers, but you may have several of the following symptoms:
Sudden change in breast size
Inflammatory breast cancer changes the appearance of the breasts, and this change can occur suddenly. Because this cancer causes inflammation and swelling, it is common to have breast enlargement or thickness. The affected breast may appear noticeably larger than the other breast or feel heavy and hard. Some women with IBC also experience breast shrinkage, where their breast decreases in size.
It can be difficult to notice subtle changes in your breast. If you've always had symmetrical breasts and you notice a sudden increase or decrease in the size of one breast, speak with your doctor to rule out inflammatory breast cancer.
Another early sign of inflammatory breast cancer is discoloration of the breast. Your entire breast or a small section may appear red, pink, or purple. The discoloration can look like a bruise, so you might shrug it off as nothing serious. But breast redness is a classic symptom of inflammatory breast cancer. Don’t ignore unexplained bruising on your breast.
In cases where breast cancer causes a lump, the tumor may not create pain or discomfort. Because there’s no pain, some women don’t suspect cancer until their doctor feels a lump during a physical examination, or until they discover one during a self-examination. The situation is different with inflammatory breast cancer.
Due to the inflammatory nature of this particular cancer, your breast will look and feel different. For example, inflammation can cause your breast to feel warm to the touch. You may also have breast tenderness and pain. Lying on your stomach can be uncomfortable, and depending on the severity of tenderness, wearing a bra can be painful. In addition to pain and tenderness, IBC can cause persistent itching around the breast.
Another telltale sign of inflammatory breast cancer is skin dimpling or pitted skin around the breast. Dimpling — which can make the skin resemble the skin of an orange peel — can develop over the whole breast or in a small area of the breast.
Change in nipple appearance
A change in the shape of the nipple is another possible early sign of inflammatory breast cancer. Your nipple may become flat or retract inside the breast. A pinch test can help determine if your nipples are flat or inverted. Place your thumb and index finger around your areola and gently squeeze. A normal nipple moves forward after pinching whereas a flat nipple doesn't move forward or backward. A pinch causes an inverted nipple to retract into the breast.
Having flat or inverted nipples doesn’t necessarily mean you have inflammatory breast cancer. These types of nipples are normal for some women and are no cause for concern. On the other hand, if your nipples “suddenly” change and become flat or inverted, speak with the doctor.
Enlarged lymph nodes
IBC can cause enlarged lymph nodes. If you suspect the disease, check the lymph nodes under your arm and above your collarbone for signs of swelling.
Cancer or infection?
If you have any of the above symptoms, you might think you have inflammatory breast cancer. Before you panic, it’s important to note that IBC symptoms can mimic those of mastitis, a breast infection.
Mastitis can cause swelling, pain, and redness around the breasts. This condition is more common in breast-feeding women, but can also develop in women who don’t breast-feed. The infection can be caused by a blocked milk duct, or bacteria entering the skin through a crack or break around the nipple.
A primary difference between mastitis and inflammatory breast cancer is that mastitis may also cause a fever, a headache, and nipple discharge. These three symptoms are not typical of IBC. Since the symptoms of mastitis and inflammatory breast cancer are similar, you should never diagnose yourself with either condition. Let your doctor make the diagnosis. If you have mastitis, your doctor may prescribe antibiotics to treat the infection. Your symptoms should improve within a couple of days. Mastitis can sometimes cause a breast abscess, which your doctor may have to drain.
If your doctor diagnoses mastitis but the infection doesn't improve or worsens, follow up with another appointment. Mastitis that doesn't respond to antibiotics could actually be inflammatory breast cancer. Your doctor can schedule an imaging test or a biopsy to diagnose or rule out cancer.
After you’re diagnosed with inflammatory breast cancer, the next step is for your doctor to stage the cancer. To do this, your doctor may order more imaging tests, such as a CT or bone scan, to see if the cancer has spread to nearby lymph nodes or other parts of the body.
Treatment for inflammatory breast cancer can include:
- chemotherapy, which is a combination of drugs to kill cancer cells
- surgery to remove the breast and affected lymph nodes
- radiation therapy, which uses high-power energy beams to destroy and stop the spread of cancerous cells
A cancer diagnosis is devastating and frightening, but your chances of beating the disease increase with an early diagnosis and beginning treatment as soon as possible. While undergoing treatment, seek support to cope with your disease. Recovery can be a rollercoaster of emotions, so it's important to learn about your condition and treatment options, and you should seek support from others. This could include joining a local support group for cancer patients and survivors, working with a therapist who helps cancer patients, as well as confiding in family and friends.