Recognizing symptoms of inflammatory breast cancer

One of your breasts was swollen and the skin looked like an orange peel. You thought it was just an infection, but your doctor thought differently. Imaging tests revealed a condition most people have never heard of – inflammatory breast cancer (IBC) – a rare and aggressive form of breast cancer.

Rebecca Aft, MD, PhD, Washington University surgeon who specializes in breast oncology and breast health explains, “Inflammatory breast cancer occurs when cancer cells have invaded the dermal lymphatics in skin covering the breast. The breasts swell and become inflamed because the cancer cells clog the vessels that carry lymph (colorless fluid containing white blood cells that circulates throughout the lymphatic system).

With IBC, a woman won’t feel a distinct lump. Instead, one of the most common symptoms of IBC is Peau d’orange – this is when the breast skin has the appearance of an orange peel. IBC tends to grow and spread quickly, with symptoms worsening within days or even hours.”

Common symptoms of IBC include:

Orange-peel appearance: Your breast may swell and start to look like the peel of a navel orange (this is called “peau d’orange”).

Redness of the breast: Redness involving part or all of the breast is a hallmark of inflammatory breast cancer. Sometimes the redness comes and goes.

Swelling of the breast: Part of or all of the breast may be swollen, enlarged, and hard.

Warmth: The breast may feel warm.

Other skin changes: The skin of the breast might look pink or bruised, or you may have what looks like ridges, welts, or hives on your breast.

Swelling of lymph nodes: The lymph nodes under your arm or above the collarbone may be swollen.

Flattening or inversion of the nipple: The nipple may go flat or turn inward.

Aching or burning: Your breast may ache or feel tender.

Dr. Aft says, “Diagnosing IBC involves a physical exam by your doctor, as well as breast imaging (mammogram) to determine if there is an underlying mass. A punch biopsy is also performed of the affected skin. This biopsy method makes is possible to evaluate into the subcutaneous fat of the breast tissue.”

The average age at diagnosis for inflammatory breast cancer in the United States is 57 for Caucasian women and 52 for African American women. These ages are about five years younger than the average ages at diagnosis for other forms of breast cancer. According to the American Cancer Society, inflammatory breast cancer is more common in African American women. A 2008 study found that being overweight makes a person more likely to develop IBC. Like other forms of breast cancer, IBC can also affect men.

“IBC is more aggressive than other breast cancers because, very early in the disease, the cancer cells invade into the dermal lymphatics,” explains Dr. Aft. “This means there is a higher likelihood that it can spread elsewhere in the body. It is important to recognize symptoms and seek prompt treatment.”

Treatment for IBC is varied and can include chemotherapy, surgery and radiation therapy. 

For more information on inflammatory breast cancer, or to make an appointment with Dr. Aft, please call 314-362-2280.

Breast Health Center 
Center for Advanced Medicine
4921 Parkview Place, Suite 5F
St. Louis, MO 63110