Inflammatory Breast Cancer or shorter,
IBC is a highly aggressive type of breast cancer. In this form of the disease the cancer cells block the lymphatic network in the skin of the breast. This form of cancer is named “inflammatory” due to the swollen , red ( “inflamed”) aspect of the breast which may occur overnight and can sometimes be misdiagnosed as another breast disease, mastitis. The edematous swelling of the breast occurs due to the impaired lymphatic drainage determined by the invasion of the regional lymphatic ducts.. Because the suspensory ligament of Cooper tethers the skin of the breast , a dimply appearance of the skin, similar to an orange peel (peau d'orange ) may occur, due to fluid accumulation.
Unlike in the other forms of breast cancer , the inflammatory breast cancer does not manifest as a
lump, ( although in many cases a dominant mass may be observed) the cancer cells forming sheets or nest, affecting the subcutaneous lymph vessels (diffuse infiltration) ; basically it looks like a rash or an infection .
Another
symptom of this disease is
breast pain, without a cyclical pattern, and which may be either constant, or stabbing. This symptom is one of the main reasons why inflammatory breast cancer is misdiagnosed as an infection and treated with antibiotics so, if a woman has been taking an antibiotic treatment for more than 7 days without any form of response a breasy biopsy or / and a refferal to a breast specialist should be considered.
The
peau d'orange aspect has an important diagnostic value, but other skin modifications may also occur. Skin discoloration, represented by an erythematous (red, pink or dark color of the skin) is highly common, and in many cases it is accompanied by pruritus, which does not relieve or decreases in intensity, not even after the use of topical agents or oral medication. The skin also presents ridges, and some areas seem thickened.
The areola (the pigmented skin surrounding the nipple) is affected by the disease and its color and texture changes and nipple abnormalities occur as well. In inflammatory breas cancer the nipple is
retracted (flattened) and in many cases, a serous or bloody nipple discharge has been observed.The skin of the nipple may also be swollen or it may presents crusts.
The breast may increase rapidly in size (a cup in a matter of days,), be warmer than usual, and many women notice that the breast is also harder and/ or firmer than before.
Since the disease affects the
subcutaneous lymph nodes, it will lead to a swelling of the ipsilateral axilary lymph nodes or even supraclavicular lymphatic group. The
lymphedema (the swelling of the arm ) occurs more rarely (only 7% of cases) and a decrease in breast size has also been documented.