All over the World, October is Breast Cancer awareness month. It’s the month of the pink ribbons everywhere, serving as a reminder of this very deadly cancer which is the second most common cancer in women.
What many people do not know is that there are actually different types of Breast cancer, some more invasive and dangerous than others. Today i’ve decided to talk about one of the less common ones – Inflammatory Breast cancer. This is inspired by a show i saw on TV recently. It’s a show called My Extraordinary Pregnancy which explores what it is like to be pregnant in extreme situations. The episode i watched was about a very brave lady named Heidi, who found out she had inflammatory breast cancer while she was in early pregnancy. She started a blog which you can check out (storminatitcup.blogspot.com) to chronicle her journey.
Her story starts with her noticing a red rash on one boob while she was still nursing her last baby. She went to see a Dr, and another Dr and both times she was diagnosed with mastitis and given antibiotics. A few months later she started to have some tiredness and vomiting which she chalked up to the stress of taking care of little kids. However she also noticed that her nipple on the affected breast was retracting and she had dimpled skin on her breast. She eventually saw a doctor who took a biopsy of the breast tissue and then she received the life changing diagnosis of Inflammatory breast cancer.
So now, let’s talk about this Inflammatory breast cancer.
What is inflammatory breast cancer?
It is a rare and very aggressive disease in which cancer cells block 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.
Most inflammatory breast cancers are invasive ductal carcinomas, which means they developed from cells that line the milk ducts of the breast and then spread beyond the ducts.
Inflammatory breast cancer progresses rapidly, often in a matter of weeks or months. In most patients, At diagnosis, inflammatory breast cancer is either stage III or IV disease, depending on whether cancer cells have spread only to nearby lymph nodes (Stage III) or to other tissues around the body as well (Stage IV)
Additional features of inflammatory breast cancer include the following:
- Compared with other types of breast cancer, inflammatory breast cancer tends to be diagnosed at younger ages. (Heidi was diagnosed at age 32)
- Inflammatory breast cancer is more common and diagnosed at younger ages in African American women than in white women.
- Inflammatory breast tumors are frequently hormone receptor negative, which means they cannot be treated with hormone therapies, that interfere with the growth of cancer cells fueled by estrogen.
- Inflammatory breast cancer is more common in obese women than in women of normal weight.
- Like other types of breast cancer, inflammatory breast cancer can occur in men, but usually at an older age than in women.
What are the symptoms of inflammatory breast cancer?
Inflammatory breast cancer causes symptoms that are often different from those of more common breast cancers. It often does not cause a breast lump, and it might not show up on a mammogram. Because it doesn’t look like a typical breast cancer, it can be harder to diagnose.
- Breast warmth
- Redness involving more than one-third of the breast
- Thickening (edema/swelling) of the skin of the breast
- The breast may become harder
- Pitting or ridging of the skin of the breast so that it may look like orange peel
These symptoms are caused by the buildup of fluid (lymph) in the skin of the breast. This fluid buildup occurs because cancer cells have blocked lymph vessels in the skin, preventing the normal flow of lymph through the tissue. Sometimes the breast may contain a solid tumor that can be felt during a physical exam, but more often a tumor cannot be felt.
Other symptoms of inflammatory breast cancer include a rapid increase in breast size; sensations of heaviness, burning, or tenderness in the breast; or a nipple that is inverted (facing inward). Swollen lymph nodes may also be present under the arm, near the collarbone, or both.
It is important to note that these symptoms may also be signs of other diseases or conditions, such as an infection, injury, or another type of breast cancer that is locally advanced. For this reason, women with inflammatory breast cancer often have a delayed diagnosis of their disease.
How is inflammatory breast cancer diagnosed?
Imaging tests
A diagnostic mammogram is usually the first test ordered. Sometimes the swelling and tenderness can make it hard to do a good mammogram. The mammogram may show thickened skin, often without a visible mass (tumor). It can also show that the affected breast is larger and denser than the other breast.
Often a breast ultrasound is ordered as well. The ultrasound is often able to show that lymph nodes under the arm are enlarged and may find breast masses (tumors) if they are present. Ultrasound can also be useful in guiding a needle for a biopsy procedure.
MRI (magnetic resonance imaging) can find breast tissue abnormalities if the mammogram result is normal. It can be used to guide a biopsy of those abnormal areas (For Heidi who was pregnant she had to avoid x-rays/mammograms to protect the baby from radiation so she had to do MRI instead)
CT (computed tomography) of the chest, abdomen, and pelvis is sometimes done to look for the spread of cancer.
A PET (positron emission tomography) scan is another test that may be useful. This test is often combined with a CT scan. PET/CT can be useful in finding areas of cancer spread to lymph nodes and distant sites.
Biopsy
Breast cancer is diagnosed by a biopsy, removing a sample of the breast tissue and looking at it under the microscope. Even though physical exam and other tests may show findings that are “suspicious for” IBC, but only a biopsy can tell for sure that cancer is present. A biopsy for IBC often involves a core needle biopsy under ultrasound or MRI guidance. IBC can also be diagnosed with a skin biopsy if no area deeper in the breast is identified on breast imaging.
If you have any of these symptoms, it does not mean that you have IBC, but you should see your doctor right away. It is very common for IBC to be misdiagnosed as mastitis, so If treatment with antibiotics is started you will need to let your doctor know if this treatment doesn’t help, especially if your symptoms worsen or the area affected gets larger. Ask to see a specialist (like a breast surgeon) or get a second opinion if you are concerned.
So tell a friend to tell a friend to tell a mother to tell a sister, pay attention to your breasts
