Breast Evaluation and Treatment Program

Breast Cancer

Inflammatory Breast Cancer

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Many women know the importance of regular breast self-exams and screening mammograms in early detection and successful treatment of breast cancer. However, one particularly aggressive type of breast cancer - called inflammatory breast cancer (IBC) - does not cause a lump or mass and usually cannot be detected on a mammogram.

Dr. Katherine Tkaczuk, director of the Breast Evaluation and Treatment Program at the University of Maryland Marlene and Stewart Greenebaum Cancer Center, provides answers to questions about this uncommon, but often deadly, type of breast cancer.

What is inflammatory breast cancer and how is it different from other types of breast cancer?

Inflammatory breast cancer is a form of invasive breast cancer in which cancer cells grow and block the lymph vessels in the skin of the breast, causing the skin to appear reddened, swollen or inflamed. It's a relatively uncommon breast cancer, accounting for only about one to three percent of all breast cancers. But, it's very serious, because it usually grows and spreads quickly. Inflammatory breast cancer forms in the lymph vessels of the breast skin, rather than as a solid tumor that can be felt as a lump.

What are the symptoms of inflammatory breast cancer?

The symptoms are very similar to the symptoms of a breast infection (mastitis), so it's important for women to be particularly aware of any changes in their breasts. Inflammatory breast cancer can cause any of the following symptoms:

Rapid swelling of the breast
Flattening or inverting of the nipple
Persistent itching of the breast or nipple
Ridges or pitting of the skin of the breast (like the skin of an orange)
Redness or discoloration of the skin of the breast
A warm or feverish area on the breast
A lump or thickening
Swelling of the lymph nodes under the arm or above the collarbone

Unlike an infection, however, inflammatory breast cancer does not respond to treatment with antibiotics.

How is inflammatory breast cancer diagnosed?

Since it does not develop as a solid tumor and usually does not show up on a mammogram, the only sure way to confirm a diagnosis of inflammatory breast cancer is through a skin biopsy or "punch" biopsy.

What are the stages of inflammatory breast cancer?

Inflammatory breast cancer is usually classified as Stage III cancer. If it has spread to the lymphatic system or other organs of the body, it is classified as Stage IV, or advanced, breast cancer.

How is inflammatory breast cancer treated?

Once a diagnosis of inflammatory breast cancer is confirmed by a biopsy, further testing may be done to see whether the cancer has spread beyond the breast. Treatment usually consists of chemotherapy, to control the spread of cancer throughout the body's lymphatic system, followed by surgery to remove the breast (mastectomy) and radiation of the chest wall.

Chemotherapy or estrogen blockers may also be given after surgery to destroy any cancer cells that may have spread to other parts of the body. Women whose cancers are HER2-positive may also be treated with Herceptin, a type of systemic therapy known as a monoclonal antibody that targets specific proteins on the cancer cells.

What should a woman do if she suspects she might have inflammatory breast cancer?

It is important for women to be familiar with their breasts and do thorough breast self-exams every month, including visual inspection of the breasts in a mirror. Any change in the appearance of the breasts should be cause for concern and should be examined by a doctor. Women who experience any of the symptoms of IBC (redness, swelling, skin discoloration, etc.) for more than two or three weeks despite treatment should see a breast specialist and have a biopsy to find out if cancer is present.

What is the prognosis for a woman with IBC?

With early diagnosis and proper treatment, inflammatory breast cancer can be cured.

Additional Resources:

To learn more about the breast evaluation and breast cancer treatment services available at UMGCC, please contact our Breast Evaluation and Treatment Program at 410-328-7904.

This page was last updated on: March 3, 2008.