Inflammatory Breast Cancer

Overview

What is inflammatory breast cancer (IBC)?

Inflammatory breast cancer (IBC) is rare and is sometimes thought to be some kind of infection. However, this kind of cancer can develop and spread quickly (said to be aggressive). It causes redness, swelling, and dimpling in the affected breast. IBC does not usually cause lumps to form in breast tissue. Instead, it appears as a rash or skin texture similar to an orange peel.

The condition results when cancer cells block lymph vessels—small, hollow tubes allowing lymph fluid to drain out of the breast.

Because IBC can grow quickly (is aggressive), it requires immediate treatment. Doctors usually treat IBC with a combination of therapies, including chemotherapy, surgery and radiation therapy.

Who is likely to have inflammatory breast cancer (IBC)?

Anyone can develop inflammatory breast cancer, including men. The condition occurs at a median age of 57 in women, which is younger than the median age for other breast cancers. It happens more often in African American women than white women, and in women who are overweight or obese.

How often does inflammatory breast cancer occur (IBC)?

IBC makes up approximately 1-5 percent of breast cancers diagnosed in the United States.

Symptoms and Causes

What causes inflammatory breast cancer (IBC)?

Inflammatory breast cancer develops when cancer cells block lymph vessels. These tubes, which are hollow, allow lymph fluid to drain out of the breast.

In most cases of IBC, cancer cells spread outward (metastasize) from lymph vessels. When cancer metastasizes, it affects the skin and other organs and is more difficult to treat.

What are the symptoms of inflammatory breast cancer (IBC)?

Symptoms of IBC usually take just 3-6 months to develop. Your symptoms may include:

  • A red or purple color or a rash spread over one-third of the breast
  • Pitting, thickening, or dimpling of skin on the breast, so that it looks like an orange peel, a condition called peau d’orange
  • Inverted or retracted nipple (a nipple that points inward)
  • Pain, swelling, itchiness, burning, or tenderness
  • Sensations of warmth or heaviness within the breast
  • Increase in the size of one breast only
  • Swollen lymph nodes near the collarbone or under the arm

Diagnosis and Tests

How is inflammatory breast cancer (IBC) diagnosed?

Lumps usually do not form with inflammatory breast cancer, making the condition harder to diagnose. A mammogram usually does not identify IBC.

Your doctor diagnoses IBC based on your symptoms, a physical examination, and test results. In some cases, doctors rule out other issues that may cause similar symptoms, like infections of the breast tissue (mastitis). Your doctor may prescribe antibiotics to treat a suspected infection. Let your doctor know immediately if antibiotics do not resolve your symptoms.

To confirm your diagnosis, your doctor takes a tissue sample (biopsy) for further evaluation in a laboratory. The biopsy results allow your doctor to stage the cancer, or determine whether it has spread outside the breast tissue. Biopsies also help doctors discover whether cancer cells may benefit from certain targeted therapies, like hormone drugs.

Your doctor may also order one of these tests to determine whether IBC has spread to other tissues:

  • Mammogram: A screening test using low-energy X-rays to create a picture of the inside of the breast
  • Ultrasound: Sound waves create pictures of the interior of breasts
  • Positron emission tomography (PET scan): Uses dye containing radioactive drugs (tracers) to view internal structures and check for diseases
  • Computed tomography (CT scan): Takes several X-rays of the breast, combining them to create a cross-sectional image
  • Magnetic resonance imaging (MRI): Using radio waves, magnets and a computer, this imaging technique forms pictures of interior body structures and processes
  • Bone scan

Management and Treatment

How is inflammatory breast cancer (IBC) treated?

Inflammatory breast cancer is usually treated aggressively. In most cases, doctors begin treatment with chemotherapy.

Many women also have surgery to remove the entire affected breast and nearby lymph nodes. This procedure is known as a mastectomy or modified radical mastectomy.

Following surgery, your doctor may recommend radiation therapy or other treatments, like hormone therapy, to target remaining cancer cells. Some people also participate in clinical trials to gain access to exploratory treatments that are not yet widely available.

What complications are associated with inflammatory breast cancer (IBC)?

Treatment for IBC can bring its own set of complications, such as lymphedema (pooling of lymphatic fluid) after removal of lymph nodes.

Because IBC develops so quickly, the condition has usually spread to other tissues (metastasis) by the time it is diagnosed. This metastasis can create a need for additional treatment to other areas of the body. IBC is also more likely to recur compared to other forms of breast cancer.

Prevention

Can inflammatory breast cancer (IBC) be prevented?

There is no way to prevent inflammatory breast cancer. You may be able to reduce your likelihood of developing the condition by maintaining a healthy weight.

For the best outcomes, early treatment is essential, including letting your doctor know about any breast changes as soon as possible.

Outlook / Prognosis

What is the prognosis (outlook) for people with inflammatory breast cancer (IBC)?

IBC usually develops quickly and spreads to other tissues outside the breast. Early diagnosis and treatment are key to managing the condition as effectively as possible.

Doctors use a system made up of four stages to diagnose all types of cancer. IBC is stage III (if it has spread to the skin only) or stage IV (if it has spread to other organs) when it is diagnosed.

Because IBC is aggressive, and because it is found later than other cancers, the outlook for people with this condition is generally not as good as for other types of breast cancer. Still, some people have lived many years after an IBC diagnosis. Your doctor can explain your individual prognosis to you.

Living With

When should I call my doctor if I am concerned about inflammatory breast cancer (IBC)?

If you notice any changes to your breast, even if you do not feel a lump, you should contact your doctor immediately. With further testing, your doctor can determine whether IBC may be a concern.

Last reviewed by a Cleveland Clinic medical professional on 10/27/2018.

References

  • American Cancer Society. Accessed 11/1/2018.Inflammatory Breast Cancer. (https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/types-of-breast-cancer/inflammatory-breast-cancer.html)
  • Breastcancer.org. Accessed 11/1/2018. Inflammatory Breast Cancer. (https://www.breastcancer.org/symptoms/types/inflammatory)
  • The IBC Network Foundation. Accessed 11/1/2018.What is Inflammatory Breast Cancer? (https://www.theibcnetwork.org/)
  • National Breast Cancer Foundation. Accessed 11/1/2018.Inflammatory Breast Cancer (IBC). (https://www.nationalbreastcancer.org/inflammatory-breast-cancer)
  • National Cancer Institute. Accessed 11/1/2018.Inflammatory Breast Cancer. (https://www.cancer.gov/types/breast/ibc-fact-sheet)

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