Inflammatory breast cancer (IBC) is a rare, aggressive form of invasive breast cancer. Usually, it doesn't start with a lump, but with a reddening and swelling of the breast and thick, pitted skin, similar to an orange peel. In the early stages, inflammatory breast cancer is often mistaken for a breast infection.

IBC starts in women about five years younger than the average age for other types of breast cancer and it can also affect men. It can grow and spread quickly, with symptoms worsening within days or even hours. That’s why it’s so important to recognize symptoms and seek treatment right away.

Tests

Mammograms
Mammograms are the fastest, most accurate way of detecting an abnormal growth in your breast. With tomosynthesis, or 3D mammography, radiology technologists can get breast images from multiple angles, enhancing the accuracy of a reading and reducing the potential need for repeat scans.

Breast Ultrasound and MRI
Your doctor may request a noninvasive imaging exam, such as breast ultrasound or breast MRI, if you have dense breasts and you’re at a higher risk of breast cancer — especially for those with a 20 percent or higher lifetime risk for breast cancer.

Ductoscopy
More than 80 percent of breast cancer growths arise in milk ducts. If your symptoms include a watery, blood-tinged discharge from the nipple, your surgeon will use ductoscopy to find the lesion to sample or remove it. It uses a fiber-optic scope less than a millimeter thick inserted into the milk duct at the nipple to send images to a computer monitor.

Biopsies
A biopsy is a small sample of the suspicious breast tissue that’s removed and tested. Biopsies can be performed in several ways, depending on the circumstances: fine-needle aspiration (minimally invasive biopsy), image-guided core needle biopsy, cyst aspiration, ductoscopy (milk ducts) and surgical biopsy (excisional or incisional biopsy).

Estrogen and Progesterone Receptor Test
This test looks for estrogen and progesterone (hormone) receptors in your cancer tissue. If your breast cancer cells have estrogen and progesterone receptors, the cancer may grow more quickly. The test tells your doctor whether treatment to block estrogen and progesterone will be effective.

Human Epidermal Growth Factor Type 2 (HER2/neu) Receptor Test
This test measures how many HER2/neu breast cancer genes there are and how much HER2/neu protein is made in a sample of breast tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer may grow or spread more quickly.

Multigene Tests
Because no tumor has a single mutation, genomic profiling allows the pathologist (cellular expert) to identify groups of mutations in your tumor tissue sample. We then can create a tumor profile for you. That profile helps us determine what type of treatment would be the most effective and how long you should have treatment.

Treatments

Chemotherapy
Chemotherapy is cancer-fighting medicine that's administered intravenously or by a pill. Chemotherapy also might be recommended before surgery, called neoadjuvant chemotherapy, to help reduce the size of the tumor and improve surgical results. Often, more than one chemotherapy medicine is used at the same time or one after the other to destroy different kinds of cancer cells that come from the same breast cancer.

If you need intravenous (infusion) chemotherapy, you can have it at the Comprehensive Treatment Unit (CTU) at Sylvester’s main location in Miami, a 12,000-square-foot unit that includes 33 recliners and 11 private rooms. If you prefer, you may have your infusion treatments at the Kendall, Plantation, Hollywood, Coral Springs, Coral Gables, and Deerfield Beach locations.

Cold Cap Therapy to Minimize Hair Loss
Sylvester offers FDA-cleared cold cap therapy to reduce hair loss during chemotherapy. The therapy works by cooling the scalp during treatment.

Targeted Therapy
Targeted therapies are treatments designed to attack the molecular changes that make the cancer cells grow and spread. The FDA has approved several targeted therapies. If your biopsy showed you're positive for HER2 receptors, you will be treated with Herceptin before surgery, in addition to having chemotherapy.

Clinical Trials
Clinical trials are research studies that test the benefits of a new drug or therapy against the current standard of care. Talk with your Sylvester oncologist to find out if a clinical trial is right for you.

Some initial research suggests that Tykerb, an HER2-targeted medicine, may be an effective therapy to treat HER2-positive inflammatory breast cancer. Tykerb disrupts the action of the HER2 protein to slow or stop cancer cell growth. Current studies are examining if Tykerb is an effective treatment for IBC, either used alone or with Taxol, a chemotherapy medicine.

Radiation Therapy
If chemotherapy hasn't helped shrink the cancer and reduce swelling, your doctor may recommend additional chemotherapy or begin radiation therapy.

After a mastectomy, it's likely you will have radiation therapy to destroy any cancer cells left behind in the area. The number and dose of treatments will depend on how well your body responded to chemotherapy and Herceptin. In most instances of inflammatory breast cancer, doctors recommend radiation therapy after surgery.

Surgery
After you have chemotherapy and possibly targeted therapy, such as Herceptin, your doctor will determine how well your body has responded to treatment. If the breast cancer has improved, your doctor will perform a modified radical mastectomy, which is surgery to remove your entire breast and some lymph nodes under your arm. Since IBC affects so much of the skin and breast, breast-conserving surgery isn't an option.

Mastectomy
A mastectomy removes the entire breast that's affected by cancer. The surgeon may remove one or more of the lymph nodes under your arm during surgery, or as a separate procedure later, to see if cancer has spread.

Why Choose Sylvester Comprehensive Cancer Center?

Sylvester is an NCI-designated cancer center. The National Cancer Institute has recognized Sylvester for its outstanding work conducting research in its laboratories, treating patients in its clinics and hospitals, and reaching out to medically underserved communities with innovative prevention strategies.

Renowned Braman Family Breast Cancer Institute at Sylvester. We offer one of the nation's best breast cancer diagnosis and care programs, offering treatments customized to your individual needs.

Breast Imaging Center of Excellence designation by the American College of Radiology. You get a more precise diagnosis, which then guides a more effective treatment plan.

Multidisciplinary breast cancer team. You receive care from a team of experts in all facets of breast cancer, offering you complete care for the best chance of success.