What Is Inflammatory Breast Cancer?

Medically reviewed by Doru Paul, MD

Inflammatory breast cancer (IBC) is a rare and aggressive (fast-growing) type of breast cancer. This condition makes up about 1% to 5% of all breast cancer cases in the United States. Inflammatory breast cancer is a type of invasive ductal carcinoma that develops in the cells that line the milk ducts in the breast. Researchers don’t know the exact cause of this type of cancer but certain risk factors, like age and obesity, can increase your odds of developing it.

Types of Invasive Breast Cancer

Inflammatory breast cancer is a rare type of invasive breast cancer. Invasive breast cancers are cancers that grow into the breast tissue. Most cases of breast cancer are considered invasive. The most common types of invasive breast cancer are:

• Invasive ductal carcinoma: Starts in the cells that line the milk ducts

• Invasive lobular carcinoma: Starts in the breast glands that produce milk

Related: What To Know About Ductal Carcinoma In Situ (DCIS)—Stage 0 Breast Cancer

Symptoms of Inflammatory Breast Cancer

Symptoms of IBC are different than typical breast cancer symptoms. Many people with this type of cancer do not feel a lump in the breast—and a lump is often not detected with a mammogram.

Inflammatory breast cancer symptoms develop quickly and usually occur in one breast. Possible symptoms include:

• Swelling

• Redness

• Breasts that are warm to the touch

• Pain

• Itching or burning sensation

• Easy bruising

• Heaviness in the breasts

• Thickening and pitting of skin (that mimics the appearance of an orange peel)

• Inverted nipples

• Swollen lymph nodes near the underarms or collarbone
  

Mastitis or IBC?

Some symptoms of inflammatory breast cancer like redness and swelling are also symptoms of a breast infection called mastitis. If you develop these symptoms, see your healthcare provider right away. If you are breastfeeding, your symptoms may be due to mastitis.

Causes

Inflammatory breast cancer occurs when cancer cells develop in the cells that line the milk ducts in the breast. Once cancer cells develop, they grow and multiply quickly. Researchers are not certain what causes cancer cells to develop in the milk ducts but believe there are risk factors that increase your chances of developing this aggressive condition.

Risk Factors

Because IBC is rare, experts still need to conduct more research to understand the underlying cause of the condition. However, research has identified some risk factors for this type of cancer, which may include:

• Younger age: The condition is often diagnosed before the age of 40

• Racial background: Black people are more likely to experience the condition than their white counterparts

• Underlying health conditions: Having obesity may play a role in the development of IBC
  

Diagnosis

Inflammatory breast cancer is aggressive and spreads quickly—and unfortunately, most people usually receive their diagnosis at an advanced stage. Once this type of cancer starts to cause symptoms in the skin (such as redness and swelling), it is classified as stage III cancer. Up to 1 in 3 cases of inflammatory breast cancer has already spread (metastasized) to other areas of the body at the time of diagnosis.

People with IBC usually seek medical advice only when symptoms develop. Because the symptoms of inflammatory breast cancer are similar to those of mastitis and other infections, your healthcare provider may recommend starting with a round of antibiotics. If your symptoms do not improve within 7 to 10 days, they will likely recommend further testing.

Diagnostic tests for inflammatory breast cancer include:

• Mammogram: May detect a lump in the breast

• Breast ultrasound: Can check for a tumor in the breast

• Breast magnetic resonance imaging (MRI): Determines if the cancer has spread

• Breast biopsy: The only test that can officially diagnose inflammatory breast cancer

• Skin biopsy: Takes a sample of the skin on your breast to check for cancer
  

Stages of Inflammatory Breast Cancer

IBC is diagnosed at stage III or stage IV, mostly because it does not cause symptoms until stage III. Here's what happens during both stages:

• Stage III: Cancer cells have spread to the skin of the breast and nearby lymph nodes. Symptoms include redness, swelling, and other skin changes.

• Stage IV: Cancer cells have spread to distant areas of the body such as the lungs or bones.
  

What Happens After Diagnosis?

Once you are diagnosed with inflammatory breast cancer, your healthcare provider will conduct further testing to determine the best treatment plan for you, such as:

• Protein testing: To detect if the cancer cells have greater amounts of the HER2 gene or the HER2 protein to understand which treatments to use

• Hormone testing: To check if the cancer cells have receptors for estrogen and progesterone to determine if hormone therapy would be beneficial to manage symptoms

Treatment

The goal of inflammatory breast cancer treatment is to achieve remission—meaning, there are no signs of the cancer being present in your body. If remission is not possible, the goal is to reduce symptoms and improve your quality of life.

If the cancer cells have hormone receptors, hormone therapy may be an option. Drugs like Nolvadex (tamoxifen) prevent estrogen from binding to its receptor. Aromatase inhibitors like Femara (letrozole) block the body’s ability to make estrogen. These drugs can help shrink the tumor in the breast.

Once the tumor has shrunk enough for surgery, your provider will discuss surgical options with you. Because IBC is almost always diagnosed at stage III or stage IV, a lumpectomy (a surgery to remove a cancerous lump) is usually not an option. A radical mastectomy (a surgery that removes the entire breast) is a common treatment option for IBC. Your surgeon may also recommend removing the nearby lymph nodes as well.

After surgery, your healthcare provider may recommend radiation therapy or targeted therapy. Your healthcare team may recommend radiation therapy to the chest wall to kill any remaining cancer cells. Radiation is usually given five days per week for six weeks. Targeted therapy uses drugs that target certain proteins on the cancer cells. If the cancer cells have high levels of HER2 protein, your provider may recommend the drug Herceptin (trastuzumab).

Some people also choose to have breast reconstruction surgery after their procedure is over. If this is something that is of interest to you, discuss this surgical option with your provider once you have completed radiation therapy.

How to Prevent IBC

Because experts are unsure about what exactly causes IBC, it's not always possible to prevent IBC. However, because obesity is a known and modifiable (changeable) risk factor, managing your weightcan sometimes be helpful. 

Complications

Inflammatory breast cancer may lead to complications as the condition grows and spreads. The most common complications are caused by metastasis (when cancer cells spread to other areas of the body). Possible complications include:

• Pain: If cancer spreads to the bones or organs, you may experience severe pain

• Kidney stones: When cancer spreads to the bone, it can lead to too much calcium in the blood (hypercalcemia) and raise your risk of kidney stones

• Neurological problems: If cancer spreads to the brain, you may experience memory problems and confusion

• Nausea and vomiting: Up to half of people with IBC have liver lesions which may cause abdominal pain, nausea, and vomiting
  

Living With Cancer

Inflammatory breast cancer is an aggressive and rapidly growing type of cancer. If you have IBC, this diagnosis has likely changed every area of your life. It is important to work with your healthcare team to develop a long-term treatment plan that focuses on managing your symptoms and improving your quality of life.

Most healthcare providers determine a person’s prognosis using the 5-year survival rate. This rate estimates the percentage of people who are living 5 years after their cancer diagnosis.

The 5-year survival rates for inflammatory breast cancer are:

To live as well as possible with this type of cancer, it may be helpful to work with several different specialists. Consider working with a dietician or nutritionist to develop a meal plan that gives your body the nutrients you need. If you are experiencing complications like chronic pain, you may want to meet with a pain specialist to reduce your discomfort. You may also choose to work with a mental health provider to learn new coping skills and discuss any psychological effects of this condition.

Frequently Asked Questions

Is inflammatory breast cancer survivable?

Yes, it is possible to survive inflammatory breast cancer. The average 5-year survival rate for all stages of inflammatory breast cancer is 39%. 

How quickly does inflammatory breast cancer progress?

Inflammatory breast cancer is an aggressive cancer that spreads quickly. Symptoms often develop over weeks to months. 

How long can you have IBC without knowing?

Inflammatory breast cancer usually develops with no signs or symptoms. Most people are diagnosed at stage III or stage IV. But because this cancer spreads quickly, you may only be at an earlier stage of the cancer for a short amount of time before your condition reaches a later stage.

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