Inflammatory breast cancer: symptoms, prognosis, survival rate, treatment.. Breast cancer caused by inflammation occurs when cancer cells obstruct lymphatic vessels beneath the surface of the breasts. Breast cancer of this type is called “inflammatory,” due to the fact that it is often swollen and red in the breast.
The incidence of inflammatory breast cancer is quite low; it represents about 1 to 5 percent of all breast cancer cases in the U.S. Breast cancers arising from inflammatory tissue are usually invasive ductal carcinomas, meaning they started as cells lining the milk ducts and eventually moved into the breast tissue.
The progression of inflammatory breast cancer is rapid, frequently occurring within weeks or months. A diagnosis of inflammatory breast cancer will rely on whether cancerous cells have migrated only to nearby lymph nodes or whether they have reached other organs as well.
Inflammatory breast cancer exhibits the following additional characteristics:
- When inflammatory breast cancer is diagnosed, it tends to occur at a younger age than most other types of breast cancer.
- Black women are more likely than white women to develop inflammation-related breast cancer at a young age.
- Breast tumors that are inflammatory are often hormone receptor negative, so they cannot be treated with hormones, such as the hormone tamoxifen, that block estrogen-fueled cancer cell growth.
- Breast cancer caused by inflammation is more prevalent among obese women than among normal-weight women.
The incidence of inflammatory breast cancer is similar to that of other breast cancer types, but it occurs in men at an older age than in women.
Inflammatory breast cancer is characterized by swelling (edema) and redness (erythema) that affect one-third or more of the breast. There is also the possibility of pink, reddish-purple, or damaged breast tissue. Similar to the orange’s skin (known as peau d’orange), the skin can also have ridges or appear pitted.
Symptoms of these conditions are caused by the accumulation of fluid (lymph). In the skin, cancer cells have blocked lymphatic vessels, interfering with the normal flow of lymph through the tissue, resulting in fluid accumulation. Sometimes during a physical exam, you can feel a solid tumor in the breast, but more often than not, it’s not detectable.
Asymptomatic inflammatory breast cancer can also cause rapid breast growth, heaviness, burning, or soreness in the breast, and an inverted nipple (on the inward side). The swelling of lymph nodes can occur under the arm, near the collarbone, or both.
A short time after the first symptom appears, other symptoms may appear. An example, fatigue, nausea, or pain are symptoms that only a person experiencing them can identify and describe.
Please keep in mind that symptoms of these diseases or disorders can also indicate other conditions, such as the presence of an infection, an injury, or another form of locally advanced breast cancer. Consequently, inflammatory breast cancer patients usually go undiagnosed for a longer period of time.
It is usually considered the prognosis, or expected outcome, for a cancer patient to be whether cancer will be successfully treated and the patient will fully recover. Patients’ age, general health, and how well their cancer responds to treatment, in addition to the type, stage, and location of their cancer, are all factors that might affect their prognosis.
The illness progresses rapidly and spreads aggressively to other parts of the body, so women diagnosed with inflammatory breast cancer do not live as long as those diagnosed with other types of breast cancer.
Additionally, you have to remember that survival statistics are based on a large number of patients and that the prognosis of an individual woman may vary depending on her cancer features and medical history. It is important for women with inflammatory breast cancer to talk to their doctor about their specific circumstances based on their prognosis.
Our ongoing studies, particularly those at the molecular level, will provide more insight into how inflammatory breast cancer develops and progresses. As a result of this insight, novel medicines could be developed and prognoses could be improved for women diagnosed with this disease. It is vital for women with inflammatory breast cancer to discuss the possibility of participating in clinical trials with their doctors.
The inflammatory form of breast cancer may be difficult to detect. Physical examinations often fail to detect a lump and screening mammograms do not reveal it. Furthermore, inflammatory breast cancer patients generally have thick breast tissue, meaning a mammogram may have a more difficult time detecting cancer.
Inflammatory breast cancer can also develop between mammograms and develop rapidly because it is so aggressive. There is a risk that inflammation associated with breast cancer may be confused with the symptoms of mastitis, an infection or another form of locally advanced breast cancer.
To help doctors avoid delays in the diagnosis and treatment of inflammatory breast cancer, an international group of experts produced guidelines on how to accurately detect and stage the disease. These guidelines are summarized below.
The following are the minimum diagnostic criteria for inflammatory breast cancer:
- The development of rapid erythema, edema, a peau d’orange appearance (ridged or pitted skin), and/or an abnormal breast temperature. The lump may or may not be palpable.
- For less than 6 months the symptoms above were present.
- Approximately one-third of the breast is covered by erythema.
- Invasive carcinoma is found in the biopsy samples taken from the affected breast.
The next step in treating HER2-positive breast cancer is to look for hormone receptors in the tissue (estrogen and progesterone receptors) or higher levels of the HER2 gene and/or the HER2 protein (HER2-positive breast cancer).
Staging and imaging tests include the following:
- Imagining the breast and regional lymph nodes (nearby) with a diagnostic mammogram and ultrasound
- PET scans or CT scans and bone scans to see if the cancer has spread elsewhere
By diagnosing and staging inflammation-related breast cancer correctly, doctors can determine the optimal treatment strategy and predict the progression of the disease. A patient diagnosed with inflammatory breast cancer is advised to speak with a specialist who specializes in this type of cancer.
Inflammatory breast cancer patients have a survival rate of 41% after 5 years. A patient’s survival rate depends on a number of factors, including the stage, grade, and type of cancer as well as the treatment given. In cases where the cancer has spread to the regional lymph nodes, 56% of patients survive in five years.
Compared to other breast cancer types, IBC tends to have a lower survival rate.
According to the U.S. Cancer Statistics Office, there is a median survival rate of approximately 57 months for people with stage III IBC. Stage IV IBC is estimated to have a median survival rate of 21 months or just under 2 years.
The usual treatment for inflamed breast cancer includes systemic chemotherapy to reduce the tumor, followed by surgery to remove it and radiation therapy. These treatments are known as multimodal treatment approaches. Researchers have found that women with inflammatory breast cancer who receive multimodal treatment respond more favorably to therapy and live longer. In a multimodal treatment strategy, the following treatments can be utilized.
When this type of chemotherapy is given before surgery, it is often performed with anthracyclines and taxanes. It is generally recommended that four to six cycles of neoadjuvant chemotherapy are administered over the course of four to six months before a tumor is removed unless the illness progresses during this period and doctors decide the surgery should not be delayed.
Treatment of inflammatory breast tumors is possible because HER2 production is higher than normal in these tumors, thus medicines targeting this protein, such as trastuzumab (Herceptin), are used. HER2 inhibitor therapy can be used as neoadjuvant therapy or as adjuvant therapy following surgery.
Women whose inflammatory breast cancer cells contain hormone receptors may be treated with hormone therapy. The drugs tamoxifen and letrozole can stop estrogen-dependent cancer cells from growing and killing them. Tamoxifen prevents the attachment of oestrogen to its receptor, and letrozole inhibits the body’s ability to make its own estrogen.
Inflammatory breast cancer is typically treated by a modified radical mastectomy. When performing this surgery, both the afflicted breast and the lymph nodes under the arm to which it is adjacent are removed. The lining covering the underlying chest muscles is often removed as well, but the muscles themselves are usually intact. Occasionally, the lesser chest muscle (pectoralis minor) is also removed.
In addition to post-mastectomy radiation therapy, some patients with inflammatory breast cancer receive radiation therapy under the breast that was excised. After a woman has had trastuzumab before surgery, she may continue taking it during postoperative radiation therapy. Women with inflammatory breast cancer can undergo breast reconstruction, but doctors often recommend delaying reconstruction because radiation therapy is so important to the treatment of this disease.
The risk of cancer recurrence may be reduced by adjuvant systemic therapy after surgery. In addition to chemotherapy, hormone therapy, targeted therapy (such as trastuzumab), or any combination of these therapies may be used in addition to this.
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