What to know about inflammatory breast cancer

A lump is the most common and widely recognized symptom of breast cancer. But in one aggressive form of breast cancer, you are more likely to notice changes in the texture or appearance of the breast.

Inflammatory breast cancer typically does not cause breast lumps, making it difficult to detect in a routine breast exam or mammogram. The condition often progresses quickly and is rare, accounting for 2% to 4% of breast cancer cases in the U.S., according to the National Library of Medicine. It also contributes to 7% of breast cancer deaths.

“Inflammatory breast cancer often presents as an enlarged, swollen and reddened breast,” says Dr. Celeste Cruz, a breast cancer surgeon at Advocate Health Care. “Unlike other forms of breast cancer, there’s no lump. Instead, the skin may develop a pitted appearance, which is sometimes compared to the texture of an orange peel. This is caused by cancer cells invading the dermal lymphatics, which are located just beneath the skin.”

When doctors approach any breast cancer treatment, understanding the biology of the tumor is the first place they should start, Dr. Cruz says.

Various factors are considered when evaluating treatment options, including:

• How fast is the cancer growing?
• Does the cancer look and act like normal breast tissue with estrogen and progesterone receptors? Doctors may be able to provide a medication that blocks these hormones in the breast tissue to help kill the cancer.
• What is the growth factor receptor? Some breast cancers develop a receptor called HER-2, which binds to the growth factors in the brain or heart muscles. This may affect the course of treatment.

“Inflammatory breast cancer can be quite aggressive,” Dr. Cruz explains. “Its biology varies, and in many cases, it metastasizes quickly, often before it’s detected.”

For most patients diagnosed with inflammatory breast cancer, treatment typically starts with chemotherapy, she says.

The next step is usually surgery to remove the breast and the axillary nodes, or the lymph nodes in the underarm where breast cancer commonly will spread. Radiation to the chest wall is the last step in the treatment process.

“While it is rare to see a complete recovery, especially when the cancer has already spread before detection, some patients do respond to treatment and achieve remission,” Dr. Cruz says.

Take a free online quiz to learn your breast cancer risk or find a cancer expert in Illinois or Wisconsin.