Inflammatory breast cancer

This information is about a rare type of breast cancer called inflammatory breast cancer. Ideally it should be read with CancerBACUP’s general information about cancer of the breast.

Inflammatory breast cancer

In inflammatory breast cancer, the cancer cells may not grow as a lump that can be felt in the breast, but they grow along and block the tiny channels (lymph vessels) in the skin of the breast. In some people the body will react to the cancer cells in the lymph vessels and as a result the breast looks inflamed (which is how the condition gets its name) and swollen. The lymph vessels are part of the lymphatic system, which is responsible for removing fluid from tissues and collecting and filtering out bacteria and any waste materials that the body’s cells do not want.

Signs and symptoms

The symptoms often develop quite suddenly. The breast looks red and inflamed and feels warm and swollen. Ridges or raised marks may appear on the skin of the breast, or the skin may have a pitted appearance, like the peel of an orange (known as peau d’orange).

Other symptoms may include a lump or thickening in the breast, pain in the breast or nipple, or a fluid (discharge) coming from the nipple.

How it is diagnosed

The appearance of the breast during examination may suggest the diagnosis to your doctor. Certain tests will be needed to help make the diagnosis and to find out whether the cancer has spread.

Mammogram (breast x-ray) 

Mammograms may be used to look for changes in the affected breast and to check the other breast.

Ultrasound scan 

In this test, sound waves are used to make up a picture of the breast tissue. It is done in the hospital’s scanning department. A small device like a microphone is then rubbed over the breast area. The sound waves are converted into a picture using a computer. The test is completely painless and takes 5–10 minutes.

Biopsy 

This is the most important test to find out if cancer is present. A small piece of tissue is taken from the breast and sent for examination under a microscope to check for signs of cancer. This is usually done using a local anaesthetic, which numbs the area. A biopsy may also be taken from the lymph nodes under the arm to see whether any cancer cells are present there.

Treatment

Often a combination of different treatments will be needed. These include chemotherapy, radiotherapy, hormonal therapy and surgery. For most types of breast cancer, surgery is usually the first treatment. However, with inflammatory breast cancer it is more usual to give chemotherapy or hormonal therapy first.

Chemotherapy

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The chemotherapy helps to treat and control the disease in the breast itself and any cancer that may have spread beyond the breast to other parts of the body.

Hormonal therapy

Hormonal therapies can slow or stop the growth of breast cancer cells either by altering the levels of particular female hormones that are naturally produced in the body, or by preventing the hormones from being taken up by the cancer cells.

There are many different types of hormonal therapy and they work in slightly different ways. Letrozole, anastrozole and exemestane are the most commonly used for inflammatory breast cancer. They are only used to treat postmenopausal women.

Radiotherapy

Radiotherapy, which treats cancer by using high-energy rays to destroy the cancer cells, may be given to the breast area after chemotherapy or hormonal therapy.

Surgery

Following chemotherapy or hormonal therapy some women may have surgery to remove all or part of the breast. Most women who have surgery will have radiotherapy afterwards.

Research trials

Research into treatments for inflammatory breast cancer is ongoing and advances are constantly being made. Cancer doctors use clinical trials to assess new treatments. Before any trial is allowed to take place, an ethics committee must have approved it, and agreed that the trial is in the interest of patients.

You may be asked to take part in a clinical trial. Your doctor must discuss the treatment with you so that you have a full understanding of the trial and what it means to take part. You may decide not to take part or withdraw from a trial at any stage. You will then receive the best standard treatment available.

Your feelings

You may experience many different emotions including anxiety and fear. These are all normal reactions and are part of the process many people go through in trying to come to terms with their condition. Many people find it helpful to talk things over with their doctor or nurse. Close friends and family members can also offer support.

CancerBACUP has a section on the emotional effects of cancer and how to deal with them.

References

This section has been compiled using information from a number of reliable sources.

• Oxford Textbook of Oncology (2nd edition). Eds. Souhami et al, Oxford University Press, 2002.
• Cancer of the Breast (5th edition). Eds. Donegan and Spratt, Saunders, 2002.
• Improving outcomes in breast cancer – the research evidence. National Institute of Clinical Excellence, 2002. 

For further references, please see the general bibliography.