Inflammatory Breast Cancer

Inflammatory breast cancer is a type of breast cancer that causes the breast to swell and the skin to change. A key sign is an enlarged breast with skin that's thickened and often appears red, purple, or bruised. Imagine the skin looking like it's been irritated or inflamed.

This happens because cancer cells grow in the breast tissue. These cells then detach and travel through the tiny channels (lymphatic vessels) under the skin. When these cells block the lymphatic vessels, they can't drain properly, causing the skin to swell and change color. The swelling can make the breast feel warm to the touch.

Importantly, inflammatory breast cancer is usually already advanced. "Advanced" means the cancer has spread beyond its original location in the breast to nearby tissues and possibly nearby lymph nodes. This is why early detection is crucial.

It's very important to remember that inflammatory breast cancer can easily be mistaken for a breast infection. Breast infections are much more common. If you notice any changes in your breast skin, like redness, swelling, or dimpling, see a doctor right away. Early diagnosis and treatment are key for better outcomes. Don't delay seeking medical attention if you have concerns about your breast health.

Inflammatory breast cancer is different from other types of breast cancer. It usually doesn't form a noticeable lump. Instead, it shows up through changes in the breast. These changes often happen quickly, over a few weeks. Key signs include:

• Changes in breast appearance: One breast may look different, becoming noticeably thicker, heavier, or swollen. The skin might change color, becoming red, purple, pink, or even bruised-looking.

• Feeling hot or warm: The affected breast might feel unusually warm to the touch.

• Skin texture changes: The skin on the affected breast might look dimpled or have ridges, like an orange peel.

• Pain, tenderness, or aching: The breast might be painful, tender, or ache.

• Swollen lymph nodes: Swollen lymph nodes under the arm, above the collarbone, or below the collarbone can also be a sign.

• Nipple changes: The nipple might become flattened or pulled inward (inverted).

It's important to note that these symptoms must be present for less than six months for a diagnosis of inflammatory breast cancer.

Important Note: Many other conditions can cause similar symptoms. For example, a breast injury or infection (mastitis) can lead to skin changes, swelling, and pain. Inflammatory breast cancer can easily be mistaken for a breast infection, which is much more common. Therefore, it's common to first be treated with antibiotics for a week or more.

What to do:

• If your symptoms improve with antibiotics, no further testing is needed. This is a good sign that the problem is likely a less serious infection.

• If your symptoms don't improve with antibiotics, contact your doctor. This is important because inflammatory breast cancer is a serious possibility. Your doctor may recommend more tests to determine the cause.

• If you've been treated for a breast infection but your symptoms persist, contact your doctor immediately. This is crucial to rule out more serious conditions, like inflammatory breast cancer. Your doctor may order a mammogram or other tests.

Diagnosis:

The only way to confirm a diagnosis of inflammatory breast cancer is through a biopsy. This involves removing a small tissue sample for laboratory testing. This is the gold standard for diagnosing inflammatory breast cancer, and it's important to follow your doctor's advice to get the appropriate testing done.

If you notice any breast changes that worry you, see a doctor right away.

Many other, more common conditions, like a breast injury or infection (mastitis), can have similar symptoms to inflammatory breast cancer. For example, both can cause changes in breast skin color, swelling, and pain.

Because mastitis is much more common, it's very typical to be treated with antibiotics for a while. If the antibiotics work, then no further tests are needed. But if your symptoms don't get better after a week or two of antibiotics, your doctor might suspect a more serious problem, like inflammatory breast cancer.

If you've been treated for a breast infection but your symptoms persist, call your doctor. They might order a mammogram or other tests to figure out what's going on. The only way to know for sure if you have inflammatory breast cancer is to have a small piece of tissue tested in a lab.

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A woman's breasts are made up of many tiny parts. Think of a daisy: each breast has about 15 to 20 sections, or lobes, of tissue. These lobes are further broken down into even smaller parts called lobules. The lobules are where milk is made for breastfeeding. Tiny tubes called ducts carry the milk to a storage area just under the nipple.

Inflammatory breast cancer happens when the DNA inside some cells in the breast changes. DNA is like a set of instructions for the cell. Normal cells have instructions for growing and dividing at a certain rate, and for dying at a specific time. But in cancer cells, the changed DNA gives new instructions. These new instructions make the cancer cells multiply very quickly and live much longer than normal cells. This rapid growth and survival of cancer cells leads to too many cells building up in the breast.

Typically, these changes start in the milk ducts, the tubes that carry milk to the nipple. But sometimes, the cancer begins in the lobules, where milk is produced.

In inflammatory breast cancer, the cancer cells break free from where they started. They move into the tiny channels (lymphatic vessels) under the skin of the breast. These cancer cells multiply and block the lymphatic vessels. This blockage causes the skin of the breast to change color, swell, and sometimes develop dimples. These changes in the skin are a key sign of inflammatory breast cancer.

Inflammatory breast cancer is a type of breast cancer that's more common in women than men. Everyone has some breast tissue, and therefore anyone can get breast cancer. However, some factors increase the chance of developing this specific type of cancer.

One significant risk factor is age. Inflammatory breast cancer is often diagnosed in people between the ages of 40 and 50.

Another important factor is race. Studies show that Black individuals have a higher risk of developing inflammatory breast cancer compared to white individuals.

Obesity is also linked to an increased risk of inflammatory breast cancer. Maintaining a healthy weight is important for overall health, and this includes a reduced risk of certain cancers.

It's essential to remember that these are just risk factors. Having one or more of these factors doesn't guarantee someone will get inflammatory breast cancer. If you have concerns about your risk, it's crucial to talk to your doctor. They can help assess your individual situation and discuss any necessary steps to take.

Taking steps to improve your health can potentially lower your risk of breast cancer. Here are some things you can do:

Breast Cancer Screening: Talk to your doctor about when you should start getting screened for breast cancer. Discuss the pros and cons of different screening tests. Together, you can figure out the best screening plan for you.

Breast Awareness: Regularly checking your breasts for any changes can help you become familiar with how they normally look and feel. This is called breast self-awareness. If you notice a new lump, change in texture, or anything unusual, tell your doctor right away. Knowing your breasts well can make it easier to spot any changes early. Breast self-awareness doesn't prevent breast cancer, but it can help you notice potential problems.

Alcohol Consumption: If you drink alcohol, limit it to no more than one drink per day. There is no safe amount of alcohol when it comes to preventing breast cancer. If you're very worried about your risk, you might choose not to drink at all.

Exercise: Aim for at least 30 minutes of moderate-intensity exercise most days of the week. If you haven't been active recently, talk to your doctor about starting an exercise program safely and gradually. Even small amounts of activity can be beneficial.

Hormone Therapy: Combination hormone therapy can increase your risk of breast cancer. Talk to your doctor about the risks and benefits of hormone therapy if you are considering it. If you are experiencing uncomfortable menopausal symptoms, you and your doctor can decide if the benefits of hormone therapy outweigh the risks. If you do use hormone therapy, use the lowest dose possible for the shortest time needed.

Weight Management: Maintaining a healthy weight is important. If you need to lose weight, talk to your doctor about safe and effective ways to do so. This might involve eating fewer calories and gradually increasing your activity level. Losing weight gradually and under medical supervision is key for your health.

Diagnosing Inflammatory Breast Cancer

Inflammatory breast cancer is diagnosed by looking at your health history, examining your breast, and performing various tests. It's a process that involves a conversation with your doctor, a physical check-up, and some specialized tests.

Here's how doctors figure out if you have inflammatory breast cancer:

• Physical Exam: Your doctor will carefully examine your breast for any changes. These might include changes in skin color (like redness or swelling), dimpling of the skin, or other unusual signs that could suggest inflammatory breast cancer.

• Imaging Tests: These tests create pictures of the inside of your body. A mammogram (breast X-ray) and ultrasound are common ways to look for possible signs of cancer in the breast. Sometimes, an MRI (magnetic resonance imaging) is also used. These tests help doctors see if there are any suspicious areas.

• Biopsy: A biopsy is like taking a small tissue sample. Doctors might use a needle to remove a tiny piece of tissue from the area suspected to have cancer. Sometimes, a small sample of skin is also taken for testing. The tissue sample is then sent to a lab for examination to see if it's cancerous.

If inflammatory breast cancer is diagnosed, more tests are needed to see how far it has spread. This is called determining the cancer's stage.

• Cancer Staging: To determine the stage, doctors may use more imaging tests. These tests might look for cancer in your lymph nodes or other parts of your body, like the lungs, liver, or bones. These tests help figure out how advanced the cancer is, which is critical for creating the best treatment plan. Common staging tests include MRIs, CT scans (also called CAT scans), bone scans, and PET scans (positron emission tomography).

Important Note: Not everyone needs every test. Your doctor will decide which tests are most appropriate for you based on your specific situation.

• Cancer Stages: Breast cancer stages range from 0 to 4. Lower stages (0-2) usually mean the cancer is smaller and hasn't spread much. Higher stages (3-4) indicate the cancer is more advanced. Inflammatory breast cancer tends to be aggressive and grow quickly, so it often shows up in stages 3 or 4. By stage 4, the cancer has spread to other parts of the body, such as organs and bones.