Inflammatory Breast Cancer: Symptoms, Diagnosis and Treatments
Inflammatory breast cancer is a very rare form of breast cancer. However, unlike more common forms of breast cancer, with this type of cancer the cells may not be felt as a lump in the breast. Instead the cells spread along and block the lymph vessels in the skin of the breast. Sometimes this causes the breast to appear inflamed and perhaps swollen.
Symptoms of inflammtory breast cancer can develop suddenly and can sometimes mimic mastitis. For this reason, it can often be overlooked, particularly if it develops in a breastfeeding woman or a woman who is pregnant or has recently given birth. However, since it will not respond to antibiotics, your doctor should consider inflammatory breast cancer if you are presenting with the same symptoms repeatedly.
Inflammatory breast cancer can cause the breast to look sore, feel warmer than usual and even swell. The skin of the breast may also look different from normal, perhaps with ridges or raised marks on the surface, or it may develop pits and look like orange peel.
Additionally, there may be a lump or some thickening of the breast tissue and some women also experience nipple or breast pain or leakage from the nipple.
Diagnosing Inflammatory Breast Cancer
In some instances, just by examining your breast, your doctor will suspect inflammatory breast cancer. However, further tests will also be required in order to confirm these suspicions. The tests will indicate whether the cancer is contained or whether it has spread to other parts of the body.
Biopsy
A biopsy, ie, a small sample of breast tissue will be taken from the breast and sometimes also from the lymph nodes under the arm. These are examined to check for cancerous cells. This procedure is usually painless, although in some instances a local anaesthetic may be offered.
Mammogram
You may be offered a mammogram (ie, a breast x-ray) which will look for breast changes. Both breasts are usually examined. Again, this is usually a painless procedure, although it can be a little uncomfortable for some women.
Ultrasound
An ultrasound scan of the breast may also be offered. During an ultrasound, sound waves help to form an image of the breast tissue. Again, the procedure is painless and is very like the scan used to measure the development of a foetus during pregnancy. Gel is placed on the breast and a small scanner is moved across it. The soundwaves appear on a computer monitor as an image.
After Diagnosis of Inflammatory Breast Cancer
Because inflammatory breast cancer can spread rapidly, treatment is usually started immediately. You will be given several different treatments which work together to help fight the disease.
Treatment is usually a combination of chemotherapy, radiotherapy, hormonal therapy and surgery. In most cases of breast cancer, surgery will be the first step. However, in the case of inflammatory breast cancer, chemotherapy is often given first.
Chemotherapy
Chemotherapy is a treatment which uses specialised anti-cancer drugs. These destroy the cancer cells in the breast and help to reduce swelling. It also targets and treats any cancerous cells that may have spread.
Surgery
Following chemotherapy, most women suffering from inflammatory breast cancer will be offered surgery.
Many women will have the whole breast removed although sometimes it may be possible to just remove the affected part of the breast. This is a decision you will take with your doctors.
After any surgery, you will probably need to embark on a course of radiotherapy and hormonal therapy to help prevent a return of the cancer.
Hormonal Therapy
With some forms of breast cancer oestrogen receptors are present on their surface. This is known as oestrogen receptor positive (ER+) breast cancer meaning the cancerous cells need the hormone oestrogen to grow. Oestrogen is a naturally-occuring female hormone produced in the body. Sometimes it causes breast cancer cells to divide and grow.
If you have ER+ breast cancer, you will probably be prescribed hormonal therapy. This treatment helps counteract the effects of oestrogen and it can can reduce or stop the growth of breast cancer cells. It does this by altering the levels of naturally produced female hormones, or by blocking the hormones from being taken up by the cancer cells.
Your doctor will decide which course of hormonal therapy is best suited to your particular requirements.
Radiotherapy
Radiotherapy is also used in the treatment of inflammatory breast cancer. Using high-energy x-rays, cancer cells are destroyed whist normal cells are protected as much as possible. It may be useful in preventing the risk of the cancer returning after chemotherapy and surgery.
Trastuzumab (Herceptin®)
Herceptin is a fairly new addition to the treatments used for breast cancer. It belongs to a group of drugs called monoclonal antibodies.
Some breast cells divide and grow when a protein known as human epidermal growth factor, attaches itself to another protein called HER2. Herceptin attaches itself to the HER2 protein, thus blocking this process meaning the epidermal growth factor cannot reach the breast cancer cells.
Some breast cancer cells have much more HER2 receptors than others. The tumour is then described as being HER2-positive. Herceptin® only works if you have high levels of the HER2 protein (HER2 positive). You will be tested to discover whther this is the case in your situation.
Herceptin® is used to treat both early breast cancer or secondary breast cancer (ie breast cancer which has spread)
Research into Inflammatory Breast Cancer
There is lots of research into treatments for inflammatory breast cancer and your doctors may ask if you would be willing to become a trialist. If you agree, then your doctor will discuss the treatment you will be trialing in depth to ensure you understand what you will be getting into. You are never obliged to complete any of these trials but you will always receive the highest standards of care whichever treatment you opt to go for.
Coping with Inflammatory Breast Cancer
As with any type of cancer, you will probably feel a mixture of emotions during and after your diagnosis and treatment. Although family and friends will rally round and do their best to help, it can also be helpful to chat to people unrelated to you. Many cancer patients don't wish to burden their relatives with their feelings (even though this may not be how their family feel!) but if you are finding it difficult to cope then it can be useful to have a chat with your doctor or a specialised cancer nurse.
See also:
Related Breast Cancer Articles
Breast Cancer TNM Staging System
Further Information
For further information and breast cancer support, please visit Macmillan Org
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