What is inflammatory breast cancer?

This page was reviewed under our medical and editorial policy by

Daniel Liu, MD, Plastic and Reconstructive Surgeon.

This page was reviewed on February 4, 2022.

Inflammatory breast cancer (IBC) is a rare form of breast cancer that makes up 1 percent to 5 percent of breast cancers in the United States. It occurs when cancer cells block the lymph vessels (which carry lymph fluid and white blood cells throughout the lymphatic system) in the breast, and it gets its name from the “inflamed”—think: red, swollen and dimpled—appearance of the breast skin. Many women describe is as a rash.

While the cancer is rare, it’s aggressive and fast-growing, which makes it all the more important to be aware of its signs and symptoms—and to get a quick and accurate diagnosis if they arise. Many women want to know what the first signs of IBC are, how quickly it progresses and how it’s diagnosed and treated. To help answer these questions, this article covers:

If you believe you may be experiencing symptoms of IBC and want to schedule an appointment for diagnostic testing, or if you’re interested in a second opinion for breast cancer, call us or chat online with a member of our team.

How is IBC different from other types of breast cancer?

Unlike with other types of breast cancers, 85 percent of people diagnosed with inflammatory breast cancer have no lump. That’s why it can be mistaken for breast infections or injuries because of the redness and swelling it causes. While it’s possible to detect IBC on a mammogram, the imaging device may not recognize evidence of disease because the cancer forms in layers.

More women than men are affected by IBC, and it tends to be seen in younger women (under 40) than other breast cancers. Black women are also at a slightly higher risk of the disease than white women, and being overweight or obese is also known risk factor for IBC.

What are the symptoms of inflammatory breast cancer?

IBC symptoms can develop quickly over several weeks. They are a result of lymph vessels becoming blocked and white blood cells building up. Inflammatory breast cancer symptoms include:

  • Large patches of redness
  • Red bumps that resemble bug bites, sometimes referred to as "inflammatory breast cancer rash"
  • Swelling and warmth on the breast
  • Dimpling or a thickness to the skin, giving it the texture and appearance of an orange peel
  • Flat, inverted, bruised-looking nipple
  • Heaviness in the affected breast
  • Aching
  • Itching
  • Generalized pain

These blockages may also cause the lymph nodes under the arm or around the collarbone to become swollen. If you’re pregnant or breastfeeding, some of these symptoms might be mistaken for a common breast infection called mastitis. This is caused by breast tissue inflammation that usually affects people who are lactating, and they may or may not have an infection. You may initially be diagnosed with this condition and sent home with antibiotics. It’s important to talk to your doctor if your symptoms don’t go away in seven to 10 days. Unlike an infection, inflammatory breast cancer symptoms do not tend to come and go.

How early can IBC be diagnosed?

Because of IBC’s quick-growing and aggressive nature, combined with its tendency to be misdiagnosed, it’s commonly diagnosed at an advanced stage.

  • IBC tends to grow in layers, which is why it can be missed during exams.
  • On imaging, these sheets of tissue can resemble nests.
  • Your doctor may be able to feel these areas of thickening on your skin, as well as possibly see areas of higher density on a mammogram.
  • Routine blood tests may not pick up abnormalities related to inflammatory breast cancer.

Tests for inflammatory breast cancer

Doctors determine a diagnosis based not just on the breast's appearance, but on the results further testing, which may include:

  • A biopsy that removes a small sample of affected tissue in your breast to be examined in a lab
  • Biopsy results that show whether you have the HER2 protein, which is present in about 20 percent of breast cancer cases
  • The determination of hormone receptor status, or whether you have more hormone receptors than usual within the cancer cells

Knowing whether your cancer has any of these characteristics will help you and your care team make informed treatment decisions.

If the biopsy results in an inflammatory breast cancer diagnosis, your doctor will likely order a breast magnetic resonance imaging (MRI) to detect how much of the breast tissue and lymph nodes are affected, and whether the other breast has been affected (which is rare). You may have other tests performed, including positron emission tomography (PET) scan, computed tomography (CT) scan and bone scan, to also see whether the cancer has spread to any other parts of the body.

What are the stages of IBC, and what do they mean?

IBC doesn’t usually appear like typical breast cancer, and it may be hard to catch early. Because of this, by the time IBC is diagnosed, it’s progressed to a more advanced stage. IBC is a type of cancer that grows into the skin, which means it’s already at stage 3 when it develops. So, while it forms in the milk ducts, there's no way to know a person has the disease until outward signs appear. Usually, you'll see changes in your skin because the lymph vessels are blocked. Like other types of breast cancer, IBC tends to spread to nearby lymph nodes first.

Part of the diagnostic process involves your care team determining the specific stage of breast cancer. These include:

  • Stage 3B, which means cancer has spread to nearby areas of the breast, such as the ribs and muscles in the chest or the skin
  • Stage 3C, which means the tumor is larger or has spread to nearby tissues (The lymph nodes around your breast could be affected as well.)
  • Stage 4, which means the cancer has spread to other areas of the body

It’s important for an accurate and timely diagnosis and staging so treatment can be started without delay.

How is inflammatory breast cancer treated?

Treatment for IBC usually starts out with chemotherapy, followed by surgery and breast cancer radiation therapy.

  • Recommendations for chemotherapy cycles average six cycles over a span of four to six months.
  • Radiation therapy is generally given five days a week for five to six weeks.

The goal of chemotherapy for breast cancer is to shrink the tumor or tumors as much as possible before surgery so the oncologist can surgically remove as much cancer as possible. If your cancer is HER2-positive, you may also undergo a targeted therapy. If your hormone receptor status was positive, your provider may suggest hormone therapy.

A total mastectomy is usually indicated for people with IBC, and if your provider finds cancer in the lymph nodes, these organs may be surgically removed as well. Many people with IBC have radiation therapy following surgery. It’s possible to have breast reconstruction, but because radiation therapy is so important in IBC, it’s recommended to wait until after your radiation is finished.

Consider getting a  second opinion or even several opinions to be sure you’re comfortable with your surgical team and that you’re getting the information you need to make a decision that’s right for you.

Clinical trials are also an important avenue in order to receive state-of-the-art care and new treatment options, while also helping doctors improve available treatments. Clinical trials for cancer compare new treatments to standard care. Your cancer care team can help you find and evaluate potential clinical trial options for IBC. Trials are supported by several organizations, including the National Cancer Institute (NCI), and several listing search services are available online, such as NCI’s Steps to Find A Clinical Trial.

What are the survival rates for IBC?

IBC is a fast-growing and aggressive cancer. However, many factors may influence your outcome from IBC:

  • The location, stage and whether or not the cancer has spread all can affect how you respond to treatment.
  • Age and overall health also play a role.

While it’s true that this type of cancer has a lower survival rate than other forms of breast cancer, it’s important to remember that your situation is unique, and statistics are generated from previous patients and past treatments.

With localized IBC, meaning it hasn’t spread to other organs, the five-year survival rate is about 39 percent. However, statistics on survival depend on several factors, including the cancer’s stage and the type of treatment you have. For instance, if cancer has spread to other organs in the body, the survival rate is about 18 percent. But if the cancer has spread to only nearby lymph nodes, the survival rate averages about 52 percent.

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