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Inflammatory breast cancer (IBC) is a rare, very aggressive type of breast cancer that accounts for 1-5% of all U.S. breast cancer cases, according to The National Cancer Institute (NCI). It often occurs in young women in the 30-40 age range, so any change in one or both breasts calls for immediate attention.

Common signs of IBC are:

• Redness or rash of the breast
• Persistent itching of breast or nipple
• Rapid increase in breast size
• Body aches and fever
• Dimpling or ridging of the breast (compare to the exterior of an orange)
• Pain or soreness of breast
• Enlarged lymph nodes under the arm or above the collarbone
• A lump does not have to be present for IBC

“The unfortunate part is that once a woman notices these symptoms, she’s probably moved beyond the initial stages,” says Beth Layhe, D.O. “That’s why her symptoms needs to be checked, either by an internist or surgeon familiar with breast cancer. It’s not uncommon for the patient to be put on antibiotics, because the inflammatory symptoms are the same as those for mastitis, or breast infection.

“If symptoms do not start to improve within a few days of antibiotics, the patient should ask to be referred for a biopsy. If the biopsy proves positive for IBC, a Positive Emission Tomography (PET) scan will likely be ordered for staging the cancer. The patient will have an electrocardiogram, or MUGA scan to make sure the heart can tolerate the chemotherapy drugs we plan to use. And if the woman’s veins are poor, we insert an infusion port.

“We use a neo-adjuvant approach to IBC, which means several rounds of chemotherapy are given before moving on to surgery and radiation therapy. With IBC, the skin is swollen and filled with fluid. That has to be addressed prior to surgery. We also want to kill or shrink the size of cancerous cells so surgery is most effective.

“Normally, we use Adriamycin as part of the chemotherapy regimen. We test for HER2, a type of breast cancer where Human Epidermal Growth Factor Receptor-2 overexpresses in tumor cells. If a patient tests positive for HER-2/neu, Herceptin will be the part of the treatment regimen as well.

“With aggressive treatment, 33% of patients survive for at least 10 years or more. The five-year survival rate is about 50%. IBC is not a new cancer, and until the last decade, there was no cure. Though reoccurrence is high, I have seen some patients for their annual check-up after their initial diagnosis and treatment for IBC who are still doing well.

“After chemotherapy, a mastectomy is recommended, followed by radiation to the chest wall. We tell patients that even after chemotherapy, surgery and radiation, recurrence rates remain high for IBC. Sometimes, additional chemotherapy is recommended. However, I see patients for their annual check-up 15 years after their initial diagnosis and treatment for IBC.

“Early detection is the key. The earlier we find a cancer like IBC, the more aggressive we can be with treatment, and the better the outcome is likely to be. I tell women: ‘If you notice anything unusual about your breasts, see your doctor right away. IBC is generally a young person’s cancer, and it mimics mastitis very well. So, if antibiotics haven’t been effective in 2-3 days, get a referral to a breast care center or specialist for a biopsy. Every day counts in defeating IBC.’”

Editor’s Note: Beth Layhe, D.O., is a board-certified hematologist/oncologist and board-certified oncologist in private practice as Medical Oncology Associates, PLLC., 2901 Stabler St.