Inflammatory Breast Cancer

Inflammatory Breast Cancer 
By: Mona Williams-Gregory, PhD, DNP, APRN

Inflammatory breast cancer is a rare, very aggressive cancer that accounts for up to 5% of all breast cancers in the US¹. At the time of diagnosis, inflammatory breast cancer is usually stage III or IV¹. As many as 30% of cases involve metastasis². Identifying inflammatory breast cancer can be challenging because symptoms emerge rapidly and may be mistaken for an acute inflammatory process like mastitis³. It is more common among African American women, women under 40, and women who are overweight or obese². As a result of lymphatic fluid buildup within the breast, clinical manifestations include bruising or redness, swelling, warmth, pain, itching, dimpling of the skin, or pulling of the nipple^1-3.  Traditional mammography may not be useful in diagnosing inflammatory breast cancer. Most women with inflammatory breast cancer do not have a lump and their breast tissue is dense¹. These factors make mammography less definitive, but it can be useful in identifying lymph node involvement. An ultrasound, PET scan, CT scan, or bone scan can also be used to evaluate metastasis¹. A breast biopsy is used to definitively diagnose inflammatory breast cancer^1-3. The standard of care for nonmetastatic inflammatory breast cancer employs a trimodal approach of systemic chemotherapy followed by modified radical mastectomy and radiation^1-3. The survival rate for women with inflammatory breast cancer is lower than that of women with other types of breast cancer^1-4. But outcomes associated with this trimodal approach have favorable control rates⁴, which highlights the importance of early detection and prompt treatment of inflammatory breast cancer. Let’s use breast cancer awareness month as an opportunity to educate our patients about inflammatory breast cancer.

References

1. National Institute of Health (NIH). (2016, January). Inflammatory breast cancer. https://www.cancer.gov/types/breast/ibc-fact-sheet
2. American Cancer Society. (2022, March). Inflammatory breast cancer. https://www.cancer.org/cancer/breast-cancer/about/types-of-breast-cancer/inflammatory-breast-cancer.html

3. Susan G. Komen. (2022, May). Inflammatory breast cancer. https://www.komen.org/breast-cancer/treatment/by-diagnosis/inflammatory-breast-cancer/

4. Hester, R. H., Hortobagyi, G. N., Lim, B. (2021). Inflammatory breast cancer: Early recognition and diagnosis is critical. American Journal of Obstetrics & Gynecology, 4, 392-396. DOI: https://doi.org/10.1016/j.ajog.2021.04.217