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The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on April 2, 2021.

Inflammatory breast cancer overview

Inflammatory breast cancer (IBC) is a rare form of breast cancer that makes up one to five 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 your breast, and it gets its name from the “inflamed”—think: red, swollen and dimpled—appearance of your skin.

How is IBC different from other types of breast cancer?

Unlike with other types of breast cancers, only 15 percent of people diagnosed with IBC have a lump. That’s why it can be mistaken for breast infections or injuries because of the redness and swelling that’s present. While it’s possible to detect IBC on a mammogram, it’s usually not diagnosed this way because of how 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. In addition, Black women are at a slightly higher risk of IBC than white women. Being overweight or obese is also known risk factor for IBC.

Symptoms

IBC symptoms can develop in three to six months. They are a result of lymph vessels becoming blocked and white blood cells building up. These symptoms include:

  • Large patches of redness
  • Swelling and warmth on your 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 your arm or around your 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.

Diagnosis

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.

Your doctor can make a diagnosis based on the appearance of your breast, but further testing is necessary to make sure.

  • You’ll likely have a biopsy that removes a small sample of affected tissue in your breast to be examined in a lab.
  • The biopsy will show whether or not you have the HER2 protein, which is present in about 20 percent of breast cancer cases.
  • Your doctor will also want to know your hormone receptor status, or whether or not you have more hormone receptors than usual within the cancer cells.

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

If the biopsy shows inflammatory breast cancer, your doctor will likely order a breast magnetic resonance imaging (MRI) to find out how much of the breast and lymph tissue is affected, and if the other breast has been affected, too (which is rare). You may have other tests done, 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.

Different stages of IBC

IBC doesn’t usually appear like typical breast cancer, and it can 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 III when it develops. So, while it starts in the milk ducts, there's no way to know a person has the disease until outward signs appear. Usually, you'll see changes on your skin because the lymph vessels are blocked.

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

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

Treatment options

Treatment for IBC usually starts out with chemotherapy, followed by surgery and 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 is to shrink the tumor or tumors as much as possible before surgery so that 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 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.

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.

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.