Inflammatory breast cancer is a invasive breast cancer that affects the blood vessels in the skin of the breast
Breast cancer usually begins like a single tumor – a tough and generally painless lump within the breast or underarm area. But an uncommon form of the disease, inflammatory breast cancer, doesn’t result in the typical breast cancer symptoms and can be much more dangerous as a result.
“Most breast cancers begin in the [milk] duct system from the breast and grow being an enlarging mass,” says Christy Russell, MD, an affiliate professor of medicine in the Keck School of Medicine at the University of Southern California, chief of drugs at USC/Norris Cancer Hospital, co-director from the USC/Norris Breast Center, along with a spokeswoman for the American Cancer Society. But inflammatory breast cancer differs. “We usually cannot determine where it started,” she says. “When you are feeling the breast, you cannot find one area of the breast in which the mass started. The entire breast feels abnormal. Inflammatory breast cancer is usually harder to treat because when it is detectable, it’s already at an advanced stage.
Inflammatory Breast Cancer
Inflammatory breast cancer is the place cancer cells block the lymph glands within the skin of the breast. It’s known as “inflammatory” because the breast usually becomes red, warm, and swollen, and also the problem can be easily mistaken for any breast infection. It’s usually diagnosed in young women and African-American women, however it makes up only 1 to five percent of breast cancer cases in the usa.
Causes Inflammatory Breast Cancer
In this type of cancer, the cells of cancer often do not form lumps within the breast. Instead, the cells of cancer block the lymph vessels that normally keep lymph fluid relocating the breast. Once the normal flow of lymph fluid is blocked, it will make the breast look swollen and red and feel warm, as though it were infected. The swelling may cause plenty of tiny dimples within the skin. Sometimes it causes a lump that grows quickly, however, you can have inflammatory breast cancer without getting a lump in your breast.
Inflammatory Breast Cancer Diagnosed
Inflammatory breast cancer can be challenging to diagnose. Often, there isn’t any lump that can be felt throughout a physical exam or observed in a screening mammogram. Additionally, most women diagnosed with inflammatory breast cancer have non-fatty (dense) breast tissue, making cancer detection inside a screening mammogram more difficult. Also, because inflammatory breast cancer is really aggressive, it can arise between scheduled screening mammograms and progress quickly. The symptoms of inflammatory breast cancer might be mistaken for those of mastitis, that is an infection of the breast, or any other form of locally advanced breast cancer.
To assist prevent delays in diagnosis as well as in choosing the best course of treatment, an international panel of experts published guidelines how doctors can diagnose and stage inflammatory breast cancer correctly.
An immediate onset of erythema (redness), edema (swelling), along with a peau d’orange appearance and/or abnormal breast warmth, without or with a lump that may be felt.
The above-mentioned symptoms happen to be present for less than 6 months.
The erythema covers a minimum of a third of the breast.
Initial biopsy samples in the affected breast show invasive carcinoma.
Inflammatory Breast Cancer Treatements
Inflammatory breast cancer is treated first with systemic chemotherapy to assist shrink the tumor, then with surgery to get rid of the tumor, then radiation therapy. This approach to treatment is known as a multimodal approach. Studies have found that women with inflammatory breast cancer who’re treated with a multi-modal approach have better responses to therapy and longer survival. Treatments utilized in a multimodal approach can include those described below.
This type of chemotherapy is offered before surgery in most cases includes both anthracycline and taxane drugs. A minimum of six cycles of neoadjuvant chemotherapy given during the period of 4 to 6 months before trying to remove the tumor continues to be recommended, unless the disease is constantly on the progress during this time and doctors choose that surgery should not be delayed.
This type of treatment can be utilized if a woman’s biopsy samples reveal that her cancer cells possess a tumor marker that may be targeted with specific drugs. For instance, inflammatory breast cancers often produce more than normal amounts of the HER2 protein, meaning they may respond positively to drugs, for example trastuzumab (Herceptin), that target this protein. Anti-HER2 therapy could be given as part of neoadjuvant therapy after surgery (adjuvant therapy). Studies show that women with inflammatory breast cancer who received trastuzumab along with chemotherapy have better responses to treatment and survival.
If your woman’s biopsy samples show that her cancer cells contain hormone receptors, hormone treatments are another treatment option. For instance, breast cancer cells that have estrogen receptors rely on the female hormone estrogen to advertise their growth. Drugs for example tamoxifen, which prevent estrogen from binding to the receptor, and aromatase inhibitors such as letrozole, which block the body’s capability to make estrogen, can cause estrogen-dependent cancer cells to prevent growing and die.
The conventional surgery for inflammatory breast cancer is really a modified radical mastectomy. This surgery involves elimination of the entire affected breast and many or all of the lymph nodes underneath the adjacent arm. Often, the liner over the underlying chest muscles can also be removed, but the chest muscles are preserved. Sometimes, however, small chest muscle (pectoralis minor) might be removed, too.
Post-mastectomy radiation therapy towards the chest wall underneath the breast that was removed is really a standard part of multi-modal therapy for inflammatory breast cancer. If your woman received trastuzumab before surgery, she will continue to receive it during postoperative radiation therapy. If breast reconstruction is planned, the sequencing from the radiation therapy and reconstructive surgery might be influenced by the method of breast reconstruction used. If your breast implant will be used, the preferred approach would be to delay radiation therapy until following the reconstructive surgery. If your woman’s own tissues will be used in breast reconstruction, it’s preferable to delay reconstructive surgery until following the radiation therapy has been completed.