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Our Expert on Breast Health / Cancer
Q: What is inflammatory breast cancer?Ask Our Expert about Inflammatory Breast Cancer About Our ExpertAaron Bleznak M.D., is a surgical oncologist with Lehigh Valley Health Network's Lehigh Valley Surgical Oncology practice. Practicing Medicine Since 1988 Education B.A. in English, 1979, Franklin & Marshall College Residency in Surgery Montefiore Medical Center/Albert Einstein College of Medicine combined surgical departments (Chief Resident, 1987-88) Board Certification Board certified in Surgery Honors and Awards Award for Excellence as a State Chairman in Promoting Activities of the Commission on Cancer, 2005 Award from Governor Edward Rendell on Establishing PA Cancer Control Plan Award from Commission on Cancer Honoring Service as Pennsylvania State Co-Chair Named to Board of Directors, Pennsylvania Cancer Control Consortium Named to Board of Directors, American Cancer Society, Pennsylvania Division
Q: What is inflammatory breast cancer?A: Inflammatory breast cancer (IBC) is a rare type of breast cancer. Fewer than five percent of women with breast cancer have IBC, thought to be caused by cancer cells blocking the lymphatic system of the breast. Because the lymphatic system can’t drain fluids properly, the breast becomes swollen and red or “inflamed.” The skin may feel warm. Other symptoms are thickened skin, dimpled skin texture (like an orange), itching, pain or soreness. A mass or an area of firm breast tissue may be present but is not always appreciated. These changes in breast appearance can develop quickly, so see your doctor right away if you have any of these symptoms. IBC is often mistaken for mastitis, or breast infection, which is treated and often improves within one or two weeks with antibiotics. Because IBC is a very aggressive form of cancer, the cancer is often advanced by the time the patient seeks medical advice, especially if she has been treated initially for mastitis for more than a few weeks. Therefore, if you are being treated with antibiotics for mastitis, and the symptoms haven’t improved, talk to your physician about seeing a breast surgeon as soon as possible. This cancer usually affects younger women, even those in their twenties. Q: How is IBC diagnosed?A: Often, there is no defined lump as in more common breast cancers, so mammograms and ultrasounds may not show the usual findings seen with breast cancer. These studies will usually show thickening of the skin and underlying breast tissue, so they should still be performed. The doctor will examine the breast and surrounding area, noting any of the symptoms listed above. There may be enlarged lymph nodes around the collarbone or in the armpit, and the nipple may be swollen or crusted. When a defined mass is not present, a needle biopsy is more difficult to perform, and should not be trusted if it fails to reveal breast cancer. A surgical biopsy including a small area of skin is sometimes needed to make the diagnosis; cancer cells can often be seen in the skin. A MRI scan of the breast might be performed after diagnosis of breast cancer. Q: What is the treatment?A: Because this cancer is usually advanced when it is discovered, it has often spread to the lymph nodes and, at least microscopically, to other parts of the body by the time it is diagnosed. So the first treatment is chemotherapy to attempt to kill any cancer cells throughout the body. Chemotherapy has the additional advantage of shrinking the cancer in the breast and skin, which makes the next step—a mastectomy—easier and more effective. A lumpectomy isn’t recommended for women with IBC. Radiation follows the mastectomy to kill any cancer cells lingering in the breast. Reconstruction, if desired, is generally delayed until after surgery and radiation therapy in order to obtain the best possible cosmetic outcomes. Q: What’s the prognosis?A: With multiple approaches to treatment, survival rates are improving every year. However, they are still not as good as survival rates for women with more common forms of breast cancer. Right now, 25 to 50 percent of patients are survivors after five years. If you are diagnosed with IBC, don’t give up hope. Research on this disease is continuing, and new drugs and methods of treatment are being developed. This page last updated 10/15/08 12:01 AM
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