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Inflammatory Breast Cancer

Inflammatory Breast Cancer

Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer characterized by rapid growth and spread of cancer cells in the breast tissue and lymphatic vessels. It is often confused with a breast infection, such as mastitis, due to similar symptoms. Here are key points about IBC:

Symptoms

Skin changes: The breast may appear swollen, red, purple, or bruised, with a characteristic “orange peel” appearance due to blockage of lymphatic vessels.

  • Breast swelling: The breast may feel thick, heavy, or swollen.
  • Pain: Tenderness, pain, or aching in the affected breast.
  • Nipple changes: The nipple may become flattened or inverted.
  • Lymph node involvement: Enlarged lymph nodes under the arm, above the collarbone, or below the collarbone.

Diagnosis

  • Breast imaging: Digital mammography, breast ultrasound, and breast MRI are used to evaluate the breast.
  • Biopsy: A breast core biopsy and skin punch biopsy are performed to confirm the diagnosis.
  • Pathology report: The pathology report indicates the presence of cancer cells in the breast tissue and lymph vessels.

Treatment

Multidisciplinary approach: A combination of neoadjuvant chemotherapy, surgery (mastectomy), radiation therapy, hormonal therapy, and biologic targeted therapy, such as trastuzumab, is used to treat IBC.

  • Neo adjuvant chemotherapy: Chemotherapy is administered before surgery to reduce the size of the tumor.
  • Surgery: Mastectomy is often performed to remove the cancerous tissue.
  • Radiotherapy: Radiation therapy is used after surgery to prevent the cancer from recurring.
  • Hormone therapy: Hormone therapy tablets are prescribed for some years to lower the risk of the cancer coming back.

Prognosis

  • Aggressive cancer: IBC is considered an aggressive cancer due to its rapid growth and spread.
  • Survival rates: The outlook for IBC is generally worse than for other types of breast cancer, with most cases diagnosed at stage 3 or 4.

Risk Factors

  • Female gender: Compared to men, women are more likely to develop IBC.
  • Younger age: IBC is more common in women under 40 years old.
  • Black race: Black women have a higher risk of developing IBC compared to white women.
  • Obesity: Being obese increases the risk of IBC.

Prevention

  • Breast cancer screening: Regular breast cancer screening can help detect IBC early, improving treatment outcomes.

Key Points

  • Rare: IBC accounts for less than 5% of all breast cancers.
  • Aggressive: IBC is an aggressive cancer that needs to be treated thoroughly and quickly.
  • Confusion with mastitis: IBC can be mistaken for a breast infection, such as mastitis, due to similar symptoms.

How I know I had Inflammatory Breast Cancer?

To know if you have inflammatory breast cancer, you should look for the following symptoms:

Skin Changes

  • Redness or purple discoloration
  • Swelling
  • Skin ridges or dimples that resemble orange peels
  • Skin thickening

Breast Changes

  • Fast change in the appearance of one breast over several weeks
  • One breast’s thickness, weight, or enlargement
  • Unusual warmth of the affected breast
  • Tenderness, pain, or aching

Lymph Node Changes

  • Enlarged lymph nodes above or below the collarbone, or under the arm

Nipple Changes

  • Flattened or inverted nipple

Other Symptoms

  • A lump in the breast (although this is less common)

It is imperative that you see a medical professional if you encounter any of these symptoms. They will probably assess your symptoms with a mammography or other tests. A biopsy, which requires taking a sample of skin and breast tissue for microscopic inspection, is the only method to identify inflammatory breast cancer.

FAQ’s:

1: What is stage zero breast cancer?

Stage 0 breast cancer, also known as carcinoma in situ, is the earliest stage of breast cancer. It is a non-invasive condition in which aberrant cells are detected in the lobule or breast milk duct lining, but they have not proliferated outside of their original site. This stage is highly treatable and has a five-year survival rate of nearly 100%.

Breast cancer in stage 0 typically comes in two main forms:

  • Ductal Carcinoma in Situ (DCIS): Abnormal cells are found in the milk ducts, which are the tubes that milk flows through during breastfeeding.
  • Lobular Carcinoma in Situ (LCIS): Abnormal cells are found in the breast lobules, which are the glands that produce milk.

Stage 0 breast cancer often has no symptoms and is typically discovered during a routine mammogram or other screening tests. If there are any symptoms, they might include an unusual discharge from the nipples or a lump.

Treatment options for stage 0 breast cancer include lumpectomy, mastectomy, radiation, hormone therapy, and targeted cancer therapy. Some women may choose a “wait-and-watch” approach, where they undergo regular screening tests to monitor the condition without immediate treatment.

2: Good news for triple negative breast cancer?

Good news for triple-negative breast cancer includes recent progress in research and treatment options. Here are some key developments:

1: Lower Relapse Risk with High Immune Cell Levels
  • A study published in the journal Jama found that women with triple-negative breast cancer and high levels of immune cells in their tumors have a lower relapse risk after surgery, even without chemotherapy.
  • This suggests that the level of immune cells, known as tumor-infiltrating lymphocytes, can be a strong prognostic biomarker for triple-negative breast cancer.
2: New Treatment Options
  • Immunotherapy, which can assist the immune system in recognizing and eliminating cancer cells, is being studied by researchers. Pembrolizumab, an immunotherapy drug, is approved for treating triple-negative breast cancer.
  • Targeted therapies, which target specific proteins controlling cancer cell growth and division, are also being developed. These treatments can be more potent and have fewer side effects than traditional chemotherapy.
3: Improved Prognosis
  • The study mentioned above found that patients with high levels of immune cells in their tumors had a five-year survival rate of 95%, compared to 82% for those with low immune cell levels.
  • This indicates that some patients with triple-negative breast cancer may have a better prognosis than previously thought, potentially allowing for less intensive treatment.
4: Advances in Understanding and Treatment
  • Researchers are working to understand how triple-negative breast cancer grows and spreads, as well as how the immune system recognizes and fights it.
  • This increased understanding is leading to the development of new treatments and potentially more effective treatment strategies.

These developments provide hope for better triple-negative breast cancer management and treatment results.

3: How does malignant breast cancer ultrasound look like?

Malignant breast cancer on an ultrasound typically appears with certain characteristics that suggest malignancy. These features include:

  • Irregular Shape: Malignant tumors often have irregular shapes, which can be oval, round, or lobular.
  • Irregular Margins: The margins of malignant tumors are usually irregular and not well-defined, which can be spiky or angular.
  • Composition: Malignant tumors can be solid or filled with fluid, which can be detected by the ultrasound.
  • Echogenicity: Malignant tumors may have homogeneous internal echoes due to similar tissue types.
  • Posterior Echo: Malignant tumors can have posterior acoustic shadowing, which is a characteristic feature.

Radiologists can use these characteristics to identify lesions that seem suspicious and might need more research. However, it is essential to note that an ultrasound alone cannot definitively diagnose cancer or determine its stage. A conclusive diagnosis requires a biopsy.

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