Inflammatory Breast Cancer
Inflammatory breast cancer is a special kind of advanced breast cancer and it’s a serious one. Though we see an increasing number of cases, it is rare, accounting for only 1 to 4 percent of all breast cancers. Overall survival is worse in women with this kind of breast cancer than in other forms of breast cancer. It is inflammatory because its initial manifestations are usually redness and warmth in the skin of the breast, often without a palpable lump. Oftentimes, the patient and even the doctor will mistake it for a simple infection and she’ll be put on antibiotics. But it doesn’t get better. It also doesn’t get worse and that’s the tip-off: an infection will always get better or worse within a week or two – it rarely stays the same. If no change seems to be evident, the doctor should perform a biopsy of the underlying tissue to see if it is cancer.
An asymptomatic breast cancer patient was breast-feeding and developed what her doctor thought was lactational mastitis or inflammation of the breast brought about by breast-feeding. It never cleared up and did not hurt much – there was no fever sign of infection. It hadn’t gone away or gotten worse in six months. Another patient, not breast-feeding, noticed that one breast had suddenly become larger than the other; there was also redness and swelling. In both cases, the doctors at first thought the women had breast infections. So if the symptoms continue after treatment, you should ask to have a biopsy done of the breast tissue and of the skin itself. With inflammatory breast cancer, you have cancer in the lymph vessels of your skin, which makes the skin red. An internet survey done on women with the disease by a man whose wife had died of inflammatory breast cancer showed that most women said they wished they had known that when there is redness of the breast skin unresponsive to antibiotic therapy, this is indicative of inflammatory breast cancer. Probably their doctors were not breast specialists and did not know about this unusual type of breast cancer.
Inflammatory breast cancer is the only kind of breast cancer that virtually everyone agrees doesn’t call for mastectomy as its sole primary treatment. Because it involves the lymphatic vessels of the skin as well as of the breast tissue and the skin is sewn back after mastectomy (surgical removal of the breast), doing a mastectomy will leave a great chance of recurrence in the skin. Chemotherapy would be treatment of choice for this type of breast cancer before any local treatment can be entertained.
The incidence of inflammatory breast cancer is quite variable. Women with this cancer tend to be significantly younger than those with other breast cancers and African Americans with this type of cancer tend to be younger than Caucasians.
As with all advanced cancers, chemotherapy is started with three or four cycles of Adriamycin and Cytoxan with or without Taxol or Taxotere. After which local treatment can be done – usually in the form of mastectomy. After mastectomy, most women will receive four more cycles of chemotherapy followed by radiation therapy to the chest wall. Serious though it can be, inflammatory breast cancer is still an extremely variable disease.