Inflammatory Breast Cancer

Inflammatory breast cancer can be a difficult medical condition. But with the right information and support, patients can take the steps needed to start treatment early. This will improve their chances of remission and long-term survival.

Inflammatory breast cancer (IBC) is an aggressive and rare type of breast cancer that often appears as a rash or skin change rather than a lump.

The breast contains lymph vessels which drain out excess fluid from the body. In IBC, these lymph vessels become blocked by cancerous cells, causing inflammation, swelling, and a textured “peau d’orange” (orange peel) appearance of the breast skin.

Globally, it is estimated that only 1%–5% of all breast cancer cases are diagnosed as inflammatory breast cancer, making it a rare but highly aggressive condition.

Inflammatory breast cancer signs and symptoms can differ slightly from other breast cancers. For one, patients don’t get a lump in their breasts when they have this condition.

Instead, the symptoms that do show up resemble that of a rash or infection. It is due to this unusual characteristic that some patients don’t realise they may have breast cancer.

Inflammatory breast cancer causes the following signs and symptoms:

• Enlargement or swelling of the breast
• Thick, textured or discoloured skin
• Pitting or dimpling
• Inverted nipple
• The breast feels hard to touch
• Swelling in lymph nodes (armpit or under/above collarbone)
• Breast pain, tenderness, or warmth

If any of these symptoms are experienced, it is imperative to visit a Breast Cancer doctor right away. Quick intervention can help patients recognise signs of inflammatory breast cancer and get on a treatment plan immediately.

Inflammatory breast cancer can occur in both men and women, though it is more common in women. Risk factors include:

• Gender: Most cases occur in women, but men can also be affected.
• Age: IBC tends to affect younger individuals below 40, with a median diagnosis age of 57 years.
• Body weight: Obesity increases risk as fat tissue produces higher levels of oestrogen, which may fuel cancer growth.
• Race: Studies show that IBC is more common in African-American, Indian/Pakistani, and Hispanic women.

Diagnosis begins when patients notice unusual changes such as redness, breast swelling, or skin thickening. At CK Birla Hospital, our oncologists use a combination of clinical examination and advanced imaging to confirm IBC:

• Breast exam: To check for swelling, nipple changes, or skin thickening.
• Imaging tests: Mammogram, ultrasound, and MRI help detect abnormalities. A PET or CT scan may be done to check if the cancer has spread.
• Biopsy: Tissue sampling confirms the diagnosis. Pathology reports may include hormone receptor (ER/PR) status and HER2 testing. This helps determine whether the IBC is hormone-positive, HER2-positive, or triple-negative, which influences treatment decisions.

IBC is typically staged as T4d disease, meaning it is already advanced at diagnosis.

Inflammatory breast cancer is a rapidly progressing disease that starts out as Stage III cancer visible on the skin. The goal is to identify the early signs to prevent the cancer from progressing to Stage IV.

To identify which stage the IBC is at, our doctors may recommend one of the following tests:

• CT scan of the chest
• Bone scan
• MRI
• PET scan

Stage 3 inflammatory breast cancer life expectancy depends on how quickly the treatment is provided.

Additionally, the patient’s lifestyle, existing medical history, and age also matter. Based on research, the 5-year relative survival rate for IBC is between 19% and 54%.

Ultimately, the remission and survival rates differ from patient to patient. Our oncologists will be able to give the patient the right information during their consult.

When the IBC is caught at Stage III, it will still be restricted to the patient’s breast and will not spread outside. Treatments will be more effective at this time, and chances of remission will be higher, leading to longer life expectancy.

Common inflammatory breast cancer treatments include:

• Chemotherapy (Neoadjuvant): Given first to shrink the tumor before surgery. Standard regimens often include anthracycline- and taxane-based drugs.
• Surgery: Typically a modified radical mastectomy (removal of the entire breast and nearby lymph nodes). Breast-conserving surgery or immediate reconstruction is usually avoided in IBC.
• Radiation therapy: High-energy beams target residual cancer cells after surgery.
• Hormone-blocking therapy: For ER-positive or PR-positive cancers, drugs like tamoxifen or aromatase inhibitors reduce hormone-driven growth.
• Targeted therapy: For HER2-positive IBC, drugs such as trastuzumab or pertuzumab are used alongside chemotherapy.
• Immunotherapy: In triple-negative IBC, checkpoint inhibitors (immunotherapy) may be considered.

Early detection and immediate treatment of inflammatory breast cancer (IBC) are critical to improving survival rates. At CK Birla Hospital, our oncologists are highly experienced in treating IBC with a personalised plan that integrates neoadjuvant chemotherapy, surgery, radiation therapy, and targeted therapies.

Visit us or contact Dr Rohan Khandelwal today to schedule a consultation and start your journey towards recovery.