Inflammatory Breast Cancer – Diagnosis and Treatment
Diagnosis
A healthcare provider uses several steps to check for inflammatory breast cancer. The provider looks for changes in the breast, checks for cancer, and assesses how far it might have spread.
The process often begins with questions about symptoms and a close look at the breast and nearby areas.
After initial tests show signs of inflammatory breast cancer, doctors order more tests to see if cancer cells have moved beyond the breast. These steps help doctors determine the stage of treatment and choose the best treatment.
Types of Tests Used:
| Test Name | What It Checks For |
|---|---|
| MRI (Magnetic Resonance Imaging) | Detailed images of breast tissue and lymph nodes |
| CT (Computed Tomography) Scan | Cancer in the organs, chest, or abdomen |
| PET (Positron Emission Tomography) Scan | Cancer activity in the body |
| Bone Scan | Cancer spread to bones |
A doctor chooses the most appropriate tests based on the person’s symptoms and test results.
Key Areas Checked:
- Lymph Nodes: Swollen lymph nodes near the breast can suggest cancer has moved beyond its starting point. Doctors may perform a sentinel lymph node biopsy to check for cancer cells in these nodes.
- Organs: If cancer is already advanced, imaging tests examine bones, liver, lungs, and other organs.
- Breast Tissue: Doctors use imaging like mammograms and ultrasounds to see through swollen or inflamed skin and to locate any lump or abnormal area.
Symptoms Leading to Testing:
- Red, warm, or swollen breast
- Thickened skin or changes in texture
- A lump may or may not be felt
- Inverted nipple
- Changes in lymph vessels under the skin
Doctors determine the stage of inflammatory breast cancer by measuring how much the cancer has grown and how many areas, like lymph nodes or other parts of the body, have cancer cells.
Stages use numbers between 0 and 4, but inflammatory breast cancer usually appears as stage 3 or 4. This means it is bigger or has spread, so early and correct testing is key.
Doctors use the test results to plan treatment. Each patient’s test list may be different, and the care team explains why certain scans or biopsies are needed.
Treatment
Medicines That Kill Cancer Cells (Chemotherapy)
Doctors often use chemotherapy as a main part of treatment. These strong medicines are given by mouth or through a vein to kill cancer cells.
With inflammatory breast cancer, doctors usually give chemotherapy before surgery (neoadjuvant chemotherapy) to shrink the tumor and make surgery easier.
Doctors may also give chemotherapy after surgery if there is a risk that the cancer could return (adjuvant chemotherapy). The medicines are given in cycles, with breaks in between to let the body recover.
The type and number of cycles depend on the exact type of breast cancer and how it responds to medicines.
The treatment plan can change if the cancer has certain features, such as HER2 positivity or being triple-negative.
Key Points:
- Doctors may use chemotherapy before and sometimes after surgery.
- It can be given as infusions, pills, or both.
- The goal is to shrink cancer and reduce the risk of recurrence.
Removing the Breast and Lymph Nodes (Surgery)
Surgeons usually operate after chemotherapy if the cancer has not spread far. The primary surgery for inflammatory breast cancer is a total mastectomy.
The surgeon removes the entire breast, including breast tissue, ducts, lobules, some skin, the nipple, and the areola.
Surgeons often remove the lymph nodes under the arm as well (axillary lymph node dissection) to check if cancer has spread outside the breast.
Doctors sometimes discuss surgery to rebuild the breast (breast reconstruction). Most people have this done after all treatment is finished. Options for breast reconstruction include using implants or tissue from other parts of the body.
Table: Types of Surgery in Inflammatory Breast Cancer
| Surgery Type | What It Involves |
|---|---|
| Total Mastectomy | Removes the whole breast, nipple, areola, and some skin. |
| Axillary Dissection | Takes out lymph nodes under and near the arm. |
| Breast Reconstruction | Rebuilds breast shape, usually after main cancer treatments. |
Cancer-Fighting Energy Beams (Radiation Treatment)
Doctors use radiation therapy with high-energy beams such as X-rays or protons to target and destroy any cancer left after surgery. For inflammatory breast cancer, the care team aims radiation at the chest wall, underarm, and sometimes the collarbone.
Treatments usually happen five days a week for several weeks. Each session is quick, and patients lay still while a machine delivers energy to the area where the cancer was removed.
Radiation may cause side effects such as skin redness, fatigue, and sometimes swelling of the arm. The care team manages these effects to help patients complete treatment.
Medications That Target Cancer Cells (Targeted Treatments)
Targeted therapy uses drugs that focus on specific features of cancer cells. Some breast cancers have large amounts of a protein called HER2 (human epidermal growth factor receptor 2).
If the cancer is HER2-positive, doctors often use medicines that attach to HER2 proteins, blocking signals that help cancer cells grow.
These targeted therapies are designed to interfere with specific molecular features of cancer cells, making them more effective and less harmful compared to traditional treatments.
Targeted drugs can also treat other special types of breast cancer. The healthcare team tests the cancer cells to determine which targeted drugs will work best.
In some cases, these medications may be given alongside chemotherapy or after surgery, often in combination with hormone therapy, depending on the type and stage of cancer.
Blocking Hormones That Help Cancer Grow (Hormone Blocking Treatment)
Some breast cancers need hormones, like estrogen or progesterone, to grow. These cancers are called hormone receptor-positive or ER/PR-positive. Hormone therapy blocks these hormones or lowers their levels in the body, stopping the cancer from growing.
Types of hormone therapy include:
- Selective Estrogen Receptor Modulators (SERMs): These drugs block estrogen from reaching cancer cells. Tamoxifen is a common SERM.
- Aromatase Inhibitors: These medicines stop the body from making estrogen after menopause. Examples are anastrozole, letrozole, and exemestane.
- Ovarian Suppression: Medicines or surgery can stop the ovaries from making estrogen.
Doctors may start hormone therapy after surgery or radiation and continue it for five to ten years to help prevent the cancer from coming back.
Helping the Immune System Fight Cancer (Immune-Based Therapy)
Doctors use immunotherapy for certain types of inflammatory breast cancer. This treatment helps the body’s own immune system find and kill cancer cells.
It can help treat triple-negative breast cancer, which does not have HER2, estrogen, or progesterone receptors.
Some immunotherapies block proteins used by cancer cells to avoid the immune system. Doctors sometimes use it with chemotherapy for breast cancers likely to respond to this kind of treatment.
Doctors test breast cancers to see if certain markers are present before giving immunotherapy.
Support to Feel Better During Treatment (Comfort and Symptom Relief)
Palliative care provides specialized support for people with serious diseases like cancer. The care team works to reduce symptoms such as pain, nausea, and anxiety. The aim is to improve comfort and quality of life.
Doctors can provide this care at the same time as treatments like chemotherapy and radiation. Palliative care includes doctors, nurses, and social workers. They support both patients and families through the challenges of cancer treatment.
Coping and Support
Understanding Inflammatory Breast Cancer and Making Care Choices
Clear and reliable information about inflammatory breast cancer can help people feel more confident when choosing treatments. Patients can ask doctors and nurses about test results, available treatment plans, and survival rates.
Learning more about the disease can make it simpler to work with healthcare teams and make decisions that fit a person’s needs and wishes.
| Questions to Ask Medical Staff | Example Topics |
|---|---|
| What stage is the cancer? | Test results |
| What treatments are available? | Treatment options |
| What are the odds of living longer? | Survival rates |
Staying Connected with Supportive People
Strong connections with friends and family can provide both practical and emotional help. Loved ones might help by preparing meals, running errands, or just being there to listen.
When someone feels overwhelmed, having a supportive network can make daily challenges easier to face.
Ways Family and Friends Can Help:
- Help with daily tasks.
- Offer rides to doctor appointments.
- Listen when you need to talk.
Finding Trusted People to Talk To
Sometimes, it is easier to share concerns with people outside the family, such as counselors, social workers, or members of a cancer support group.
Local resources like community programs can help individuals connect with support groups. Talking with others who understand can make the journey feel less lonely.
Getting Ready for Your Doctor Visit
Steps You Can Take Beforehand
Being prepared can help make an appointment more useful. Consider the following steps:
- Ask about any special instructions. When scheduling, check if you need to do anything before the visit, such as fasting or avoiding certain medicines.
- Make a note of all symptoms. Include when they began, how often they happen, and if anything makes them better or worse. Don’t leave out changes that do not seem related.
- Write down important personal details. List major stresses, recent changes in your life, or big events that could be relevant.
- Create a complete list of medications. This should include prescriptions, over-the-counter drugs, vitamins, and supplements, plus the dose for each.
- Bring a support person. A friend or family member can help remember what the doctor says and offer support.
- Prepare questions in advance. Write down what you want to ask, with the most important questions first, such as:
| Possible Questions to Ask Your Health Team |
|---|
| Is this inflammatory breast cancer? |
| Has the cancer spread outside the breast? |
| Do I need other tests? |
| Can I see my pathology report? |
| What treatments are available to me? |
| What are the pros and cons of each treatment? |
| Is there a treatment you recommend for my case? |
| Can the treatments cure my cancer? |
| How much time do I have to make a decision? |
| Will treatment affect my daily life? |
| Should I see a specialist, and will insurance cover it? |
It’s also okay to add any other questions you think of. Writing them down can help avoid forgetting something important during the visit.
Questions Your Doctor May Ask
Doctors need details to better understand your situation. Be prepared to answer questions like:
- When did your symptoms start?
- Are they constant or do they come and go?
- How strong or severe are the symptoms?
- Have you noticed things that make the symptoms better?
- Have you seen anything that makes them worse?
Clear and honest answers help your care team learn more about your health. Bring your notes and information to make the process smoother and less stressful.
