Differentiating inflammatory breast cancer from other types of breast cancers

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Inflammatory breast cancer is a rare and aggressive form of breast cancer, which blocks the lymph vessels in the breast skin. It presents with typical symptoms of inflammation such as redness and swelling, causing the breast to look inflamed. Most inflammatory breast cancers develop from milk ducts of the breast and spread beyond the ducts as the disease progresses. Thee cancers are different from other types of breast cancers in terms of symptoms, outlook and treatment.

Signs and symptoms of inflammatory breast cancer

Various signs and symptoms of inflammatory breast cancer develop within 3-6 months. These include:

1. Redness and swelling of breast skin
2. More than one-third of the breast involved
3. Breast skin may appear pink, reddish purple or bruised
4. Thickening of breast skin (orange peel appearance)
5. Inverted or retracted nipple
6. Increase in breast size
7. Warm and heavy sensation in the breast
8. Tender, painful and itchy breast
9. Swollen lymph nodes under the arms or near the collar bone

Differentiation of inflammatory breast cancer from other types of breast cancers

Inflammatory breast cancers are associated with several factors which are distinct from other types of breast cancers. These include:

1. Inflammatory breast cancers don’t often cause breast lumps.
2. They may not show up on mammograms and are more difficult to diagnose.
3. They tend to occur in younger women, compared to other types of breast cancers.
4. They are more common in African women than in white women.
5. They commonly occur in obese/overweight women
6. They spread more rapidly than other types of breast cancers.
7. It is always at a locally advanced stage when it is first diagnosed (at least stage III)
8. In most cases, they are hormone receptor negative and cannot be treated with hormone therapies.
9. Successful treatments are difficult due to rapid spread of the disease.
10. They are associated with the worst treatment outcomes when compared to other types of breast cancers.

Diagnosis of inflammatory breast cancer

The basic criteria for diagnosing inflammatory breast cancer include:

1. Redness, swelling, orange peel appearance and abnormal warmth of the breast with or without a lump.
2. Presence of symptoms for less than 6 months.
3. Redness covering at least one third of the breast.

Other diagnostic imaging tests may include:

1. Mammogram
2. Breast ultrasound
3. Breast Magnetic Resonance Imaging (MRI) scan
4. Biopsy

Further examination of affected breast tissue is done to determine the stage of cancer, the presence of hormone receptors in the cancer cells and abnormal amounts of other proteins associated with inflammatory breast cancer.

Treatment of inflammatory breast cancerTreatment of inflammatory breast cancer

Most cases of inflammatory breast cancer are treated with chemotherapy as the first step, to shrink the size of the tumor. Chemotherapy is followed by surgery and radiation therapy, if cancer has not spread to other parts of the body. In cases where cancer has already spread to other parts, a combination of treatments may be used along with chemotherapy. These include:

1. Hormone therapy
2. Targeted therapy
3. Immunotherapy
4. Palliative care

It is important for all women to note that the symptoms of inflammatory breast cancer can easily be confused with a breast infection. Therefore, if you observe any unusual skin changes in your breast, seek immediate medical attention for appropriate diagnosis and treatment.

References:

1. Inflammatory Breast Cancer. National Cancer Institute.
   https://www.cancer.gov/types/breast/ibc-fact-sheet
   Accessed on 6 October, 2021.
2. Inflammatory Breast Cancer. American Cancer Society.
   https://www.cancer.org/cancer/breast-cancer/about/types-of-breast-cancer/inflammatory-breast-cancer.html
   Accessed on 6 October, 2021.
3. Inflammatory Breast Cancer. Mayo Clinic.
   https://www.mayoclinic.org/diseases-conditions/inflammatory-breast-cancer/symptoms-causes/syc-20355413
   Accessed on 6 October, 2021.
4. Inflammatory Breast Cancer (IBC). National Breast Cancer Foundation.
   https://www.nationalbreastcancer.org/inflammatory-breast-cancer
   Accessed on 6 October, 2021.
5. Andrea M, Barbara F, Orit F,Ruth H, Mark Clemons. Approach to inflammatory breast cancer. Can Fam Physician. 2009 Jan; 55(1): 25–31.
6. Robert H, Gabriel N, Bora L. Inflammatory breast cancer: early recognition and diagnosis is critical. Am J Obstet Gynecol. (2021);225(4):392-396.

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