By William Holaday, MD—Virtua Breast Surgeon

Inflammatory breast cancer (IBC) is rare, accounting for 1 to 5 percent of all breast cancer diagnoses in the U.S. Although IBC isn’t as common as other types of breast cancer, it’s aggressive—making it especially important for women to understand the symptoms so they can seek prompt medical treatment, if necessary. 

IBC got its name because it often makes the breast look swollen and red, giving it an inflamed appearance. The breast also may appear discolored, bruised, purple, or pink. Often, IBC causes the skin on the breast to take on a dimpled appearance similar to an orange peel. In addition, it can cause swelling in the lymph nodes under the arms, but this symptom often goes unnoticed until a health care provider discovers it during a medical exam. 

The swelling caused by IBC can lead to an uncomfortable feeling in the breast, but it doesn’t typically cause pain. It’s common for women to dismiss it as nothing and avoid seeking appropriate medical treatment. 

IBC is an aggressive cancer that can progress quickly, with symptoms usually appearing suddenly over days or weeks. If you experience IBC symptoms or signs of a breast infection, you should visit your primary care provider or OB/GYN for an evaluation. 

How IBC is diagnosed

IBC symptoms are similar to symptoms of a breast infection called mastitis, which causes inflammation. It’s sometimes difficult for a physician to tell initially whether a woman has IBC or mastitis just by examining the breast. 

The first step in diagnosing IBC is to rule out mastitis, which typically clears up quickly after a course of antibiotics. If your health care provider prescribes antibiotics and your breast symptoms don’t go away, the next step is to order an imaging study, such as a mammogram or a breast MRI, and take a biopsy of the affected breast tissue. A biopsy usually is an in-office procedure typically performed by a breast surgeon. 

Based on biopsy and imaging results, your breast surgeon will make a diagnosis. If IBC is diagnosed, the cancer is then staged. IBC progresses quickly and is usually stage III or stage IV at the time of diagnosis. Stage III means that the cancer is contained (localized) in the breast and nearby lymph nodes, and stage IV means that the cancer has spread to distant areas of the body. 

The tissue sample taken during the biopsy also is analyzed to determine the specific characteristics of the cancer. Using this information, your health care team can deliver targeted treatments for the specific tumor type. 

Treatment for IBC

IBC is a challenging form of breast cancer, but there is potential for a cure. Medications developed in the past 20 years have resulted in an improved prognosis for women with IBC. Chemotherapy and, sometimes, intravenous (IV) immunotherapy followed by surgery and radiation therapy, also can be effective. 

At Virtua, our breast cancer treatment team—that includes medical oncologists, breast surgeons, radiation oncologists, and breast cancer nurse navigators—works together with you to determine the best treatment plan and to deliver the coordinated care you need. Through the comprehensive Penn Medicine | Virtua Cancer Program, Virtua patients who meet participation criteria have the opportunity to enroll in clinical trials offered by Penn Medicine. 

Through our nationally accredited breast cancer program, Virtua also offers a range of supportive services designed especially for women who are receiving treatment for breast cancer, such as online support groups, physical therapy, hair-loss support, and more. 

Virtua’s breast specialists continue to provide follow-up care for women who are in remission after IBC treatment. Some women may receive treatment with a hormonal medication (tamoxifen or an aromatase inhibitor) during survivorship. 

If you feel the symptoms, seek immediate care

IBC is a rare, aggressive form of breast cancer that causes symptoms that can easily be mistaken for a less-serious breast infection. If you experience these symptoms, don’t delay. Visit your primary care provider or OB/GYN as soon as possible to determine the cause. 

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