1. What is inflammatory breast cancer?
Inflammatory breast cancer is a rare, fast-growing type of breast cancer.
It’s called inflammatory because the skin of the breast usually looks red and inflamed.
This is caused by the breast cancer cells blocking the tiny lymph vessels in the breast and the skin. The lymph vessels are part of the .
2. Symptoms of inflammatory breast cancer
The symptoms of inflammatory breast cancer can develop quickly.
Symptoms can include:
- Redness, warmth or swelling of the breast
- The skin of the breast changing colour or looking bruised
- Ridges or thickening of the skin
- The skin looking pitted like the skin of an orange (known as peau d’orange)
- An increase in breast size
- Persistent itching of the breast
- An inverted (pulled-in) nipple
- Swelling or lumps in the armpit or around the collarbone
- Pain or tenderness in the breast
You may or may not have a lump.
3. Diagnosing inflammatory breast cancer
What happens at a breast clinic appointment?
Inflammatory breast cancer is sometimes difficult to diagnose. This is because the symptoms are similar to some benign (not cancer) conditions such as a breast infection (mastitis) or a breast abscess. These are usually treated with antibiotics.
If you are prescribed antibiotics but your symptoms do not improve, your GP will refer you to a breast clinic.
At the breast clinic you may have several tests, including:
- A breast
- A punch biopsy – removal of breast tissue and a small circle of skin
If you are diagnosed with inflammatory breast cancer, you may have further tests to check whether the cancer has spread outside the breast. These may include:
- A PET (positron emission tomography) or CT (computerised tomography) scan
You may also have medical photographs taken of your breast to see how you respond to treatment.
If you need to have any of these tests, your treatment team will explain more about them.
4. Treating inflammatory breast cancer
Your treatment 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 quickly, treatment is usually started as soon as possible.
This usually involves treating the whole body with drugs (systemic treatment) as well as the affected breast and the area around it (local treatment).
Depending on your situation, you may have a combination of:
- Targeted therapy
- Hormone (endocrine) therapy
Chemotherapy destroys cancer cells by affecting their ability to divide and grow.
It’s given to treat and reduce the size of the cancer in the breast and to try to destroy any cancer cells that may have spread elsewhere in the body.
Chemotherapy is usually the first treatment recommended for inflammatory breast cancer, before any surgery. Because it’s the first treatment recommended, it’s called primary or neo-adjuvant chemotherapy.
Most people will have surgery after chemotherapy.
Usually the whole breast is removed, including the nipple area (mastectomy).
Your surgeon will normally remove the lymph nodes from under your arm (axilla) at the same time.
If you’re able to have breast reconstruction following a mastectomy, this is likely to be offered when you have completed all your treatment. This is called delayed breast reconstruction.
Radiotherapy uses high energy x-rays to destroy cancer cells. It’s often used after chemotherapy and surgery to treat inflammatory breast cancer.
You will usually have treatment to the whole breast area.
Depending on your situation you may be offered radiotherapy above your collarbone (clavicle), under your arm (axilla) and occasionally to the lymph nodes behind the breastbone (sternum).
Targeted therapy is the name given to a group of drugs that block the growth and spread of cancer. They target and interfere with processes in the cells that help cancer grow.
The type of targeted therapy you are given will depend on the features of your breast cancer.
The most widely used targeted therapies are for HER2-positive breast cancer. HER2 is a protein that helps cancer cells grow.
If your cancer is HER2-negative, targeted therapies for HER2-positive breast cancer will not be of any benefit.
Hormone (endocrine) therapy
Some breast cancers use oestrogen in the body to help them grow. These are known as oestrogen receptor positive or ER-positive breast cancers.
Hormone therapies block or stop the effect of oestrogen on breast cancer cells. Different hormone therapy drugs do this in different ways.
You will only be prescribed hormone therapy if your breast cancer is ER-positive.
Pre-menopausal women with ER-positive breast cancer may also be offered ovarian suppression. Ovarian suppression is the term used to describe treatments that stop the ovaries from making oestrogen, either permanently or temporarily.
Bisphosphonates are a group of drugs that can reduce the risk of breast cancer spreading in women who have been through the menopause. They can be used if the menopause happened naturally or because of breast cancer treatment.
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 treatment team, so you can decide what’s best for you.
At the end of your hospital-based treatment, you will continue to be monitored. This is known as follow-up.
How you are followed up will depend on your individual needs and on the arrangements at the hospital where you were treated. You’ll probably find your contact is more frequent at first, becoming less so as time goes on.
Your treatment team will give you a name and contact number you can use if you have any questions or concerns between appointments. This is usually for a breast care nurse. You can also talk to your GP about any concerns you have.
6. Further support
Coping with breast cancer emotionally
Being diagnosed with inflammatory breast cancer can be a difficult and frightening time.
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, you may want to see a counsellor or psychologist. Your breast care nurse, specialist or GP can arrange this.
You can also call our helpline on 0808 800 6000 and talk through your diagnosis, treatment and how you are feeling with one of our team.