Susan Dudley, PhD
Revised July 2009
“The Silent Killer: Inflammatory Breast Cancer” is a 6-minute video clip from a Seattle news program that has been making its way around the Internet. It presents some important information about inflammatory breast cancer (IBC), a very serious cancer that many women have never heard about. While the information in the video is basically sound, it has had the unfortunate unintended effect of leaving many women feeling alarmed and helpless against this condition.
Here are some essential facts about inflammatory breast cancer and what to do if you develop any suspicious symptoms:
Inflammatory breast cancer is very fast-growing and aggressive. It is also very rare – less than 5 % of all breast cancer cases, and perhaps only 1%. It occurs so infrequently that many breast care specialists have never met a patient who has it.
Inflammatory breast cancer does not typically form a lump inside the breast. Instead, the first symptoms are usually clearly visible on the breast, and they are often similar to the symptoms of relatively harmless insect bites, skin conditions, or breast infections that have no relation to cancer.
Be alert for:
- changes in the size or profile of the breast that can include a) unusual swelling or enlargement, or b) “inversion” or flattening of the nipple
- changes in the appearance of the skin that may look like a rash or bruise and may be red or purple
- changes in the texture of the skin such as thickening, development of “ridges” or of dimples or pits that look a bit like the texture of the skin of an orange
- changes in how the skin feels such as persistent itchiness or being warm to the touch
- swelling in the lymph glands that are under the arm or over the collar bone.
Even though the chances of having a rare disease like inflammatory breast cancer are extremely small, symptoms like these should never be ignored. A medical evaluation is necessary to rule out more common (and less serious) causes like simple breast infection, as well as other serious problems like Paget’s Disease of the breast (see “A New Kind of Breast Cancer?: Paget’s Disease“)
What to Do
If you have symptoms that persist for more than a few days, well-respected breast surgeon Dr. Susan Love recommends antibiotics and close watching for two weeks. If the problem is caused by a bacterial infection, the medication should result in noticeable improvement in 10-14 days. If the problem is caused by a viral infection, it won’t respond to the antibiotic so it will probably either a) get significantly worse or b) run its course and get much better in 10-14 days. Any of these outcomes is good news. On the other hand, if there is no change in the symptoms within 10 to 14 days with antibiotic treatment, you need to make an appointment with a breast specialist for a biopsy as soon as possible.
Diagnosis and Treatment
The changes that lead to a diagnosis of inflammatory breast cancer usually occur over a period of only a few weeks. It is likely that it has already spread to other parts of the body before any symptoms appear.
Mammograms are not usually effective in detecting inflammatory breast cancer. Even though an MRI exam might provide earlier diagnosis, this is not a very realistic option for women without symptoms. A biopsy is needed for an accurate diagnosis.
Treatment is similar to the treatment for other invasive breast cancers – including chemotherapy, surgery, radiation, and hormonal therapy. About half of all women with this type of breast cancer survive 5 years or longer, which is less than other types of breast cancer.
How Worried Should Women Be?
Inflammatory breast cancer is a rare disease, so the chances of your getting it is quite small. Awareness of what symptoms to look for and of how to go about having those symptoms evaluated is the most important defense against this and any disease.
Additional information about IBC can be found at: