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Inflammatory and Locally Advanced Breast Cancer

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Inflammatory and locally advanced breast cancer are accelerated forms of breast cancer that may not be detected by mammogram or ultrasound.

These are rare cancers, accounting for approximately 2% to 5% of all breast cancers. Locally advanced breast cancer may be operable (meaning that surgery might be a treatment option,) inoperable, or inflammatory.

What Are the Symptoms of Inflammatory Breast Cancer?

Unlike the more common form of breast cancer, inflammatory breast cancer does not generally show up as a lump. The disease grows as nests or sheets that clog the lymph system under the skin. Often the symptoms are attributed to other diseases and thus the diagnosis may take a long time to occur.

Symptoms of inflammatory breast cancer include:

• Pain in the breast. Often inflammatory breast cancer is mistaken as a breast infection and treated with antibiotics. If response to antibiotics doesn't occur after a week, request a breast biopsy or referral to a breast specialist.
• Skin changes in the breast area. You may find pink or reddened areas often with the texture and thickness of an orange. (peau d'orange)
• A bruise on the breast that doesn't go away
• Sudden swelling of the breast
• Itching of the breast
• Nipple retraction or discharge
• Swelling of the lymph nodes under the arm or in the neck.

These changes often occur quickly, over a period of weeks.

How is Inflammatory Breast Cancer Diagnosed?

Inflammatory breast cancer is often misdiagnosed as another medical condition. It's important to pursue a breast or skin biopsy if treatments for another breast condition like an infection don't work.

How Is Inflammatory Breast Cancer Treated?

Inflammatory breast cancer is an aggressive cancer that can spread quickly. Treatment options include:

• Surgery. If the inflammatory breast cancer has not spread beyond the breast, a mastectomy can be performed to remove the tumor. However, mastectomy has been known to increase the chance of recurrence because inflammatory breast cancer involves the lymph nodes of the skin -- and the skin is stitched together after mastectomy.
• Chemotherapy. This is often given before surgery (neoadjuvant therapy) to reduce the amount of tumor present and decrease the recurrence risk.
• High Dose Chemotherapy/Bone Marrow Transplant. Researchers are studying whether giving high doses of chemotherapy, followed by bone marrow or stem cell transplantation is effective for treating inflammatory breast cancer.
• Radiation. Often radiation is given after chemotherapy and before surgery to help reduce an inoperable cancer so surgery can be done. It may also be given after surgery to reduce the risk of the cancer coming back.

WebMD Medical Reference

Reviewed by Arnold Wax, MD, on June 20, 2009

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