Did you know that there is more than one kind of breast cancer? The media has done a very good job of reminding women that when she discovers a lump on her breast she should go to the doctor immediately. Unfortunately, there is another type of breast cancer which does not present itself as a distinct lump in the tissue, but instead grows in sheets of tissue throughout the breast. This is inflammatory breast cancer. Rather than being confined as a solid tumor it is diffuse with no palpable mass. The cancer cells will clog the lymphatic system that travel just below the skin that changes the density of the breast tissue on mammogram.
Unfortunately, some women who have inflammatory breast cancer will go undiagnosed for long periods of time, even when seeking the advice of their gynecologist or primary care physician for the reason behind the symptoms. The symptoms for inflammatory breast cancer often appear the same as mastitis, which is a breast infection. Instead of recognizing the possibility or potential for inflammatory breast cancer, some physicians will prescribe an antibiotic and wait several weeks before investigating further. (1)
The average age at the time of diagnosis for inflammatory breast cancer is 56, which is several years younger than the median age for diagnosis of breast cancer at 62. Researchers have found that a surprising number of young women had their first symptoms during pregnancy, or during breast-feeding. Because there is a misconception about the time in which this type of breast cancer can present, some younger women may have metastases before the diagnosis is even made. (2)
Symptoms for inflammatory breast cancer include swelling, usually sudden, within a few days. Some women will swell an entire cup size. The skin will be itchy, pink, red or dark-colored with a texture that similar to the skin of an orange. Sometimes ridges and thickened areas of the skin will be noticeable and the woman may experience retraction of her nipple into the breast tissue as the tissue itself swells around the nipple. There may or may not be nipple discharge that may or may not be bloody. The breast tissue is often warm to the touch and there is an aching constant stabbing pain. Many women will also experience change in the color and texture of the areola. (3)
If you have any of these symptoms you should seek the advice of your gynecologist or primary care physician immediately. Inflammatory breast cancer is very invasive and quick growing. If you are uncomfortable or dissatisfied with the answers you receive from your first physician do not hesitate to seek a second opinion. Because these cancer cells grow quickly they may metastasize before you have received an accurate diagnosis if you wait too long.
Although this type of breast cancer is rare, because of its aggressive nature it is also more dangerous. At this time, there is no real understanding of what the cause of inflammatory breast cancer is. Doctors do know that the cancer begins with an abnormal cell growth in one of the breast’s ducts. These cells divide rapidly and accumulate causing the lymphatic vessels to clog. It is the blockage of these lymphatic vessels that causes symptoms of inflammatory breast cancer.
At this time there is some disagreements about the number of women who suffer from inflammatory breast cancer but the American Cancer Society believe that it probably accounts for about 1% of all breast cancers which are diagnosed in the United States today. Because the initial diagnosis of inflammatory breast cancer is more difficult these numbers may actually be slightly higher. (4)
If inflammatory breast cancer is suspected a mammogram may be the first tests its order. It is often hard to get good imaging study because the pain and tenderness that is caused by the cancer. An ultrasound is often ordered is well, both of which may show thickened skin with a visible mass. The affected breast is often larger than the other one and will have an increased density as well. Magnetic resonance imaging is the most sensitive test for inflammatory breast cancer and will be able to measure precisely the changes.
The diagnosis is often confirmed using biopsy in which the breast tissue will be looked at under a microscope. Samples can be removed using fine needle aspiration, large core biopsy, vacuum assisted biopsy or an open biopsy. Because inflammatory breast cancer grows quickly and is more likely to spread to nearby lymph nodes, it is important to have an early diagnosis and treatment. The prognosis is not as good as it is for other types of breast cancer. The five-year survival rate, which refers to the percentage of people who live at least five years after diagnosis, is approximately 40% which compares to approximately 90% for all other breast cancers combined. (5)
These particular survival rates are based on numbers accumulated up until 2001. Because treatment protocols have advanced since then the American Cancer Society believe the newest statistics will show an increase in survival rates.
At this time the usual treatment of chemotherapy which is the use of drugs for treating cancer. These drugs can be delivered in pill form or injected by a needle into the bloodstream or the muscle. Once chemotherapy has been completed physicians may also recommend local regional treatments which may include surgery or radiation therapy. The ultimate goal is to remove these cancer cells from the body, prevent metastasis and prolong life.
Because inflammatory breast cancer is so rare, it is difficult for researchers to find adequate numbers of women to support statistically accurate research. Interestingly, other studies have shown that over the past several decades inflammatory breast cancer is become more common while other forms of advanced breast cancer have become less common. Scientists believe that some of the differences in the molecular structure of inflammatory breast cancer is responsible for the unique and aggressive way that it spreads and grows as well as the increasing numbers which we are observing.
If you experience any symptoms which you may believe are related to inflammatory breast cancer it is highly important that you seek the care of your primary care physician or gynecologist. If you are not satisfied with the answers you receive it is also very important to seek the advice of the secondary and possibly third physician in order to initiate treatment as quickly as possible.
(1) MayoClinic.com: Inflammatory Breast Cancer
(2) National Comprehensive Cancer Network: Understanding Inflammatory Breast Cancer
(3) National Cancer Institute: Inflammatory Breast Cancer
(4) American Cancer Society: Inflammatory Breast Cancer
(5) National Cancer Institute: Inflammatory Breast Cancer