Inflammatory Breast Cancer: The Silent Killer

by Johnnie Grant

Inflammatory Breast Cancer (IBC) is an aggressive, rapid-growing form of breast cancer few women know about. Usually not detected by mammograms or ultrasounds, it generally advances rapidly, and the cancer cells often spread to other parts of the body, causing more tumors (metastases). IBC requires immediate treatment with chemotherapy before surgery and is treated differently than more common types of breast cancer.

Higher Incidence among African American Women

Dr. Helen Wiest, Medical Director of Asheville Breast
Center, cites a study by K.W. Hance, et. al., in the July 2005 Journal
of the National Cancer Institute that showed that more African American
(3.1 per 100,000) women die from breast cancer than white women (2.2
per 100,000) and that women diagnosed with IBC had poorer survival (2.9
years) than women with locally advanced breast cancer (6.4 years).
“These studies showed that there was a higher incidence (among black
women) of this very aggressive form of cancer. It is crucial to get
medical attention quickly if any of the symptoms are present.”

You Don’t Have to Have a Lump to Have Breast Cancer

IBC usually grows in nests or sheets and can be diffused
throughout the breast with no palpable mass. Lacking a solid tumor, it
is easily missed on a mammogram and can be diagnosed only via biopsy.
The cancer cells clog the lymphatic system just below the skin, causing
swelling and inflammation.

Women with IBC are sometimes misdiagnosed, since the symptoms
can be similar to mastitis, a breast infection. Some doctors, not
recognizing IBC, will prescribe antibiotics. If a response to
antibiotics is not apparent after a week, a referral to a breast
specialist is warranted and a biopsy should be performed.

Younger Women Are at Risk

Age 52: Median age at time of diagnosis of IBC.
Age 62: Median age at time of diagnosis of Breast Cancer.
The misconception that young women are at lower risk for breast cancer,
coupled with the fact that IBC is so aggressive, may result in
metastases by the time the diagnosis is made. There are two documented
cases in girls as young as 12 years old and among women who are
premenopausal, perimenopausal, and postmenopausal.

Typical Symptoms of IBC include one or more of the following:
•    Swelling, usually sudden, sometimes a cup size in a few days
•    Itching
•    Pink, red, or dark colored area (called erythema) sometimes with texture similar to the skin of an orange
•    Ridges and thickened areas of the skin
•    What appears to be a bruise that does not go away
•    Nipple retraction (inversion)
•    Nipple discharge, which may or may not be bloody
•    Breast is warm to the touch
•    Breast pain (from a constant ache to stabbing pains)
•    Change in color and texture of the aureole

Trust Your Intuition, Demand a Diagnosis

IBC doesn’t show up on a mammogram. The only definitive
diagnosis is made with a biopsy. Denise Steuber, a Breast Program Nurse
at Mission Hospital, says, “When a woman has Inflammatory Breast
Cancer, the symptoms are fairly obvious.” If a doctor treats a rash on
the breast with antibiotics and it doesn’t go away, it could be IBC. If
a doctor dismisses it, get a second opinion. She tells women, ‘If you
think something is wrong with your breast, and the doctor says it’s
fine, come back in six months – don’t listen! You say, ‘No, I need to
know what this is.’”

Steuber adds, “I am here to be a resource for women,” inviting the public to call her at (828) 213-1839 with any questions.

Standard Treatments for IBC

Patients with IBC normally receive chemotherapy or radiation
to shrink the tumor before surgery. Treatment usually involves local
treatment – surgery and/or radiation therapy to the breast and underarm
– to remove or destroy the cancer in the breast, and systemic treatment
– chemotherapy and/or hormonal therapy to counteract the effects of
estrogen – to control or kill cancer cells that may have spread to
other parts of the body. Some women also have biological therapy, which
stimulates the immune system to fight the cancer. Recent studies have
shown a 50% survival rate after five years following treatment, and a
35% survival rate after 10 years.

For more information, contact the IBC Research Foundation at
www.IBCresearch.org or 1-877-STOPIBC. Another good resource, the Susan
G. Komen Breast Cancer Foundation, was founded by the sister of a young
woman who died of breast cancer (www.komen.org ).