1. What is inflammatory breast cancer?
2. What are the signs and symptoms of inflammatory breast cancer?
3. How is inflammatory breast cancer diagnosed?
4. How is inflammatory breast cancer treated?
5. Further support
Inflammatory breast cancer is a rare, fast-growing type of breast cancer. It is called inflammatory because the skin of the breast looks red and inflamed. This is caused by the breast cancer cells blocking the tiny lymph channels in the breast and the skin. The lymph channels are part of the lymphatic system.
The symptoms of inflammatory breast cancer can develop quite quickly and may include:
- redness, warmth or swelling of the breast
- the skin of the breast changing colour or looking bruised
- dimpling or ridges appearing on the skin, or the breast looking pitted like orange skin (known as peau d’orange)
- an increase in breast size
- pain or tenderness in the breast
- persistent itching of the breast
- an inverted (pulled-in) nipple
- swelling or lumps in the armpit
Inflammatory breast cancer can be difficult to diagnose. This is because the symptoms can be similar to some benign (not cancer) conditions such as mastitis (breast infection) and a breast abscess, which are usually treated with antibiotics.
If you are prescribed antibiotics but your symptoms don’t improve you will be referred to a breast clinic where you may have several tests including:
- mammogram – a breast x-ray
- ultrasound scan – uses high-frequency sound waves to produce an image
- biopsy – removal of tissue to be looked at under a microscope (you may also have a punch biopsy)
- MRI (magnetic resonance imaging) scan – this uses magnetism and radio waves to produce a series of images of the inside of the body
For more information see What to expect at a breast clinic appointment
If you are diagnosed with inflammatory breast cancer you may have further tests to check whether the cancer has spread outside the breast. These tests may include:
- CT (computerised tomography) scan, also known as a CAT scan, that uses x-rays to take detailed pictures across the body
- bone scan
If you need to have any of these tests, your specialist team will explain more about them. You can also contact Breast Cancer Care’s free Helpline on 0808 800 6000 to talk this through, or find out more information.
If you are diagnosed with inflammatory breast cancer, your specialist team will discuss your treatment options with you and prepare a treatment plan. The plan will be based on your test results.
Because inflammatory breast cancer can develop quite quickly, treatment is usually started as soon as possible. Treatment usually involves treating the whole body with drugs (systemic treatment) as well as the affected breast and the area around it (local treatment).
A combination of chemotherapy, surgery, radiotherapy, targeted (biological) therapy, hormone (endocrine) therapy and bisphosphonates may be used depending on your individual situation.
Chemotherapy is treatment using anti-cancer (also called cytotoxic) drugs to destroy cancer cells. It is usually the first treatment recommended for inflammatory breast cancer. This is called primary or neo-adjuvant chemotherapy. It is given to treat and reduce the size of the cancer in the breast and to destroy any cancer cells that may have spread elsewhere in the body.
For further information see our Chemotherapy web pages.
Following chemotherapy, most people will have surgery. Usually the whole breast is removed including the nipple area (mastectomy). Your surgeon will normally remove the lymph glands from under your arm (axilla) at the same time.
If you would like to have breast reconstruction following a mastectomy, this is more likely to be offered when you have completed all your treatment. This is called delayed breast reconstruction.
Radiotherapy uses carefully measured and controlled high energy x-rays to destroy any remaining cancer cells. It is often used after chemotherapy and surgery to treat inflammatory breast cancer. You will usually have treatment to the whole breast area, and the area above your collarbone (clavicle). You may also have treatment to the axilla (under your arm) and occasionally the lymph nodes behind the breastbone (sternum).
Targeted (biological) therapy
Targeted therapies are drugs that block the growth and spread of cancer. They target and interfere with processes in the cells that help cancer to grow.
The most widely used targeted therapy is trastuzumab (Herceptin). Only people whose cancer has high levels of HER2 (called HER2 positive) will benefit from having trastuzumab.
Pertuzumab (Perjeta) is another targeted therapy for women who have HER2 positive breast cancer. It may be given before surgery in combination with trastuzumab and chemotherapy.
If your cancer is found to be HER2 negative, then trastuzumab and pertuzumab will not be of any benefit to you.
Hormone (endocrine) therapy
The hormone oestrogen can stimulate some breast cancers to grow. A number of hormone therapies work in different ways to block the effect of oestrogen on cancer cells. Hormone therapy will only be prescribed if your breast cancer has receptors within the cell that bind to the hormone oestrogen, known as oestrogen receptor positive or ER+ breast cancer.
Bisphosphonates are a group of drugs that can reduce the risk of breast cancer spreading in post-menopausal women.
Clinical trials are research studies that aim to improve treatment or care for patients. Studies into treatments for inflammatory breast cancer are ongoing. This is something you can discuss with your doctors, so you can decide what’s best for you.
Being diagnosed with inflammatory breast cancer can be a difficult and frightening time.
There may be times when you feel alone or isolated, particularly as inflammatory breast cancer is a rare type of breast cancer. There are people who can support you so don’t be afraid to ask for help if you need it.
Some people find it helpful to discuss their feelings and concerns with their breast care nurse or specialist. If you’d like to talk through how you are feeling in more depth over a period of time, you may want to see a counsellor or psychologist. Your breast care nurse, specialist or GP can arrange this.
You can also call Breast Cancer Care’s Helpline on 0808 800 6000 and talk through your diagnosis, treatment and how you are feeling with one of our team.