Inflammatory breast cancer: Here’s all you need to know about this master of disguise
Inflammatory breast cancer can cause areas of infection or dimpling, giving the skin an orange peel appearance. In advanced cases, there may also be rashes or blisters.
Imagine noticing a swelling in your breast. It is warm, even painful. You think it's a simple infection, maybe mastitis, especially if you're a young mother or breastfeeding.
But what if it's something more serious, something that doesn't come with the usual warning signs like a lump?
Inflammatory breast cancer (IBC) is an aggressive and rare form of breast cancer that often disguises itself as a harmless condition. This makes it one of the most misunderstood and challenging types of breast cancer to catch early.
According to Prof Ronald Wasike, a breast surgical oncology and general surgeon, inflammatory breast cancer is a diagnosis of exclusion.
This means that the breast tissue, all of it, particularly the skin and the underlying tissue is inflamed (kind of hot, swollen, thickened, and painful).
Sometimes, IBC might have areas of infection or dimpling of the skin - giving it the appearance of an orange peel. Additionally, if it is advanced, there could be rashes or exfoliation of the skin with blisters.
Who is most susceptible? "It appears on very young patients between the age of 40-50, who might be lactating and more so of African race."
However, Prof Wasike shares that most doctors delay diagnosing inflammatory breast cancer because it resembles mastitis that occurs in pregnant and breastfeeding women.
So, Prof Wasike advises that when your doctor gives you antibiotics and painkillers and there is no change, you need to seek further analysis. Unlike other breast cancers that begin with lumps, these patients normally present late. The minimum it can be is stage 3A.
Prof Wasike says it grows fast. Why is that? "Because tumour cells infiltrate the lymphatics of the skin of the breast."
Treatment plan
So, for IBC, the approach to treatment, unlike these others, is what is called neoadjuvant chemotherapy.
"The aim is to reduce the swelling, to remove the tumour from the skin lymphatics so that surgery (mastectomy and axillary dissection) can be done, that is if it responds well," he explains.
"If the response is not good, then you give them radiation therapy or another set of chemo, an upgrade. Then, after surgery, you do radiation therapy," he adds.
While there are different types of mastectomies; simple, modified radical, and skin-sparing, it does not apply to IBC patients.
Prof Wasike says surgeons have to remove everything including the nodes. Only after the patient has completely healed, which could be after two years, is the silicone breast implant an option.
After they've done everything, the patients are put on maintenance chemotherapy (prevents the cancer from returning or progressing) or systemic therapy (treats cancer cells throughout the entire body), with frequent follow us thereafter.
