What is Inflammatory Brea…

When you think of breast cancer, you might imagine finding a lump in your breast or getting a call back after a mammogram. But there is a form of breast cancer that does not present with a lump, and may be very difficult to detect on a mammogram. What’s more, it often advances so rapidly that it may develop between routine screening mammograms. And you may never have heard of it: inflammatory breast cancer.

Inflammatory breast cancer doesn’t get a lot of attention in the press, for a couple of reasons. First, it’s relatively rare, making up only one to five percent of all breast cancers diagnosed annually in the United States. Second, it is often not a breast cancer story that can be wrapped up with a pretty pink ribbon in a happy ending: it has a rapid progression, and is diagnosed at Stage III or IV.

While inflammatory breast cancer, or IBC, is rare, it is important to be aware of the symptoms and to know the options should you, or someone you love, be diagnosed with inflammatory breast cancer. Prompt diagnosis can extend survival and improve quality of life.

Symptoms of Inflammatory Breast Cancer

The majority of inflammatory breast cancers are invasive ductal carcinomas. This means that the cancer developed from cells that line the breast’s milk ducts, and then spread. These tumors are often hormone receptor negative. So unlike many other breast cancers, they can’t be treated with tamoxifen and other hormone therapies.

Inflammatory breast cancer symptoms can mimic those of more common conditions, which can lead to a delay in diagnosis. Common symptoms include:

  • Swelling and redness, especially with rapid onset, on one-third or more of the breast;
  • Skin color changes on the breast, with the skin appearing pink or purplish (bruised);
  • Changes to the texture of the skin, such as looking pitted and resembling the skin of an orange, or developing a ridged texture;
  • Newly inverted nipple;
  • Sudden or rapid increase in the size of the breast;
  • Sensations of burning, heaviness, or tenderness in the breast;
  • Swollen lymph nodes in armpit or near collarbone.

Many of the symptoms above are due to a buildup of lymphatic fluid in the skin of the breast. Normally, this fluid flows through lymph vessels in the skin. With IBC, cancer cells may block those vessels, disrupting the normal flow of fluid.

While it’s possible that a woman (or man) with inflammatory breast cancer might feel a lump, it is more often the case that no lump can be felt with IBC, so don’t be lulled into a false sense of security by the absence of a lump you can feel.

That said, because IBC shares symptoms with a number of other conditions, don’t leap to the conclusion that having one or more of these symptoms means you have IBC. Having symptoms means that you should head to the doctor to get looked at and to rule out serious conditions.

Diagnosis of Inflammatory Breast Cancer

Because there is often no lump that a patient or doctor can feel, and because IBC can be difficult to pick up on a mammogram, diagnosis can be challenging. To further complicate matters, many women who have IBC also have dense breast tissue, making IBC even harder to pick up in a screening mammogram.

If a patient reports a rapid onset of breast redness and swelling, with changes to the texture of the skin on the breast, a physician should investigate further, including a biopsy of the affected breast to test for invasive carcinoma. The physician should also test the breast tissue for hormone receptors and certain genetic markers (HER2).

Doctors should also order a diagnostic mammogram and ultrasound of the breast and local lymph nodes, followed by a PET scan or CT scan, as well as a bone scan to determine whether the cancer has metastasized to other areas of the body.

Failure to perform the recommended testing for a patient who presents with symptoms of IBC could be medical malpractice.

Inflammatory Breast Cancer and Medical Malpractice

At least one case of missed diagnosis of IBC has led to a multimillion-dollar medical malpractice award for a Florida woman. The patient, a nurse and breast cancer educator, saw eight doctors before being correctly diagnosed. By the time she was diagnosed, she had to undergo debilitating treatments that destroyed her quality of life for her remaining months.

If you have symptoms of IBC, please go get them checked out promptly. We hope that it turns out to be one of the much less serious conditions with similar symptoms. And if you have any concerns that your doctors are not screening properly for IBC, please seek a second opinion.

And if you or a loved one has been diagnosed with IBC, and you believe that your doctor did not do everything he or she should have to catch it sooner, consider consulting an experienced Oregon medical malpractice attorney. You may be entitled to compensation for your doctor’s failure to diagnose you earlier.