Inflammatory breast cancer is a type of cancer that is quite aggressive and rare, in which the cancer cells leave the breast swollen, inflamed and tender. The cancer, which is considered difficult to treat because of the rate at which it grows, occurs when the cancer vessels block the lymph vessels on the skin of the affected breast.
Symptoms of Inflammatory Breast Cancer
Most of the times, Inflammatory Breast Cancer doesn’t show up on a routine mammogram or ultrasound, and it can be mistaken for a skin infection. However, it can present symptoms such as:
1. Pain or tenderness of the breast
2. Color change to the skin, giving it a bruised look
3. Increased breast size
4. Thick and reddened areas on the skin
5. Itching of the breast
6. Nipple inversion or flattened
7. Nipple discharge
8. Pitted skin like an orange peel
9. Lumps on the armpits or swelling
10. Swelling or warmth of the breast
Diagnosis of Inflammatory Breast Cancer
Inflammatory breast cancer may be difficult to diagnose, since it cannot be seen during a mammogram or ultrasound. Also, it can be mistaken for a skin infection or rash or seen as one of the benign (non-cancerous) breast conditions. Usually, it’s diagnosed through the doctor’s clinical judgement, whereby a number of tests are ordered to arrive at a conclusion of the diagnosis. These tests include:
1. MRI Scan: Magnetic and radio waves are used to produce images of inside the body
2. Mammogram: This is a breast x-ray for possible identification of the cancer cells
3. Ultrasound scan: An image of the cancer is produced using high frequency sound waves
4. Biopsy: Tissue sample is removed from the affected breast for analysis)
If the diagnosis of inflammatory breast cancer comes back positive, then more tests are done to establish if the cancer has spread outside the body. These include:
1. Scan of the bones inside the body
2. CAT Scan, which takes comprehensive photos across the body
Treatment of Inflammatory Breast Cancer
Treatment for Inflammatory Breast Cancer is usually dependent upon the test results. After diagnosis, a customized treatment plan is prepared, with has different options. Treatment is always started immediately due to the rate at which Inflammatory Breast Cancer develops, as well as its aggressiveness.
The goal of the treatment is to get rid of all the cancer cells within the breast, outside and around the breast (local treatment), as well as treatment of the entire body with specific drugs (systemic treatment). Depending on the condition or severity of the breast cancer, a combination of surgery, chemotherapy, targeted therapy, radiotherapy, hormone therapy, and bisphosphonates may be administered.
Inflammatory Breast Cancer Treatments
1. Chemotherapy
Chemotherapy treatment is a combination of anti-cancer cells used before surgery to either completely destroy or slow down the growth of the cancer cells throughout the body. Chemotherapy is generally the first treatment for inflammatory breast cancer that is recommended.
2. Surgery
After the chemotherapy treatment, surgery is the next stage for most people diagnosed with Inflammatory Breast Cancer. A full mastectomy is done, whereby the affected breast and the nipple are removed. In most cases, the lymph glands under the arm will be removed as well during the surgery. Depending on each case, the patient might undergo a breast reconstruction surgery after completing all the treatments.
3. Radiotherapy
Radiation therapy comes after chemotherapy and surgery with a goal of destroying any cancer cells and reduce the chances of it recurring. The highly controlled and carefully-measured high energy x-rays target the entire breast, the lymph glands under the arm as well as those behind the breast bone.
4. Hormone (Endocrine) therapy
Since some cancers can be stimulated by hormone estrogen, different hormone therapies can be used to stop the effect of estrogen hormone on cancerous cells. This mode of treatment is only considered if the inflammatory cancer cells test positive for receptors, which bind to the estrogen.
5. Targeted (biological) therapy
If the inflammatory breast cancer cells have more than normal the amount of human epidermal growth factor receptor 2 gene (HER2), treatment drugs such as such as trastuzumab (Herceptin) which specifically target it may be given to treat it. And if the cancer tests positive for HER2 Pertuzumab (Perjeta), which is another targeted therapy, may be given. On the on the other hand, if your cancer is negative for HER2, then the drugs will not be administered.
6. Bisphosphonates
Bisphosphonates are drugs that are used to either slow down or prevent bone damage. When used for cancer treatment in post-menopausal women, they reduce the risk of the inflammatory breast cancer spreading.
Recovery After Inflammatory Breast Cancer
After the successful inflammatory breast cancer treatment, your doctor will keep a close watch on you. Follow-up appointments are required as agreed with the breast doctor, where he/she will do tests for signs of recurrence. A mammogram and screening might be required every 6 to 12 months.
Next Steps
At King’s College Hospital London Dubai, our Breast Care Clinic caters to every type of breast cancer and breast conditions. If you are facing any kind of abnormal changes to your breast, regardless how small, get in touch for a consultation with one of our breast doctors. For more information on breast cancer and breast care, book an appointment below.
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