Kenneth R. Hirsch
Inflammatory breast cancer is an uncommon, aggressive form of the illness that can quickly spread to other parts of the body. This form of breast cancer accounts for approximately 1 to 5 percent of breast cancers in the U.S., according to the National Cancer Institute. Inflammatory breast cancer (IBC) causes early symptoms not typically seen with other breast cancers. These symptoms occur due to spread of the disease into the lymphatic channels of the breast skin.
Breast Discoloration and Warmth
Discoloration of an area of skin on one breast is commonly the earliest symptom of IBC. The area often initially appears pink or mottled. Over a short period -- typically within weeks -- the discoloration deepens to a red or purple hue and commonly enlarges. The involved area typically encompasses at least one-third of the affected breast but may involve a larger portion of the breast skin. The red area commonly feels warmer to the touch than unaffected skin, and it might feel itchy.
As breast discoloration evolves with IBC, the affected breast typically enlarges. This symptom occurs due to fluid accumulation within the breast caused by blockage of the lymph channels by breast cancer cells. The enlargement may escape your notice initially but lymphatic fluid buildup tends to increase with time, which can cause the affected breast to feel heavy or tender. You might notice that the affected breast no longer fits comfortably into the cup of your bra. In some cases, breast enlargement caused by IBC leads to doubling of the size of the involved breast.
Skin Dimpling and Distorted Breast Shape
Blockage of the lymphatic channels caused by IBC leads to fluid accumulation within and swelling of the affected skin of the involved breast. This skin swelling often leads to dimpling at the hair follicles, causing the involved skin to resemble the skin of an orange. Uneven distribution of complete or partial blockage of the lymph channels can also lead to changes in the normal breast shape. This can manifest as raised areas or ridges in the affected breast. Most people with IBC do not have a lump that can be felt when examining the breast.
Nipple Changes and Enlarged Lymph Nodes
Inflammatory breast cancer can cause nipple changes as an early warning sign of disease. You may notice that your nipple appears unusually flat, or it might be inverted -- appearing depressed rather than protruding from the front of the breast. Because IBC tends to spread quickly, it can travel to nearby lymph nodes early in the course of the disease. This type of spread can lead to enlarged lymph nodes under your arm or above your collarbone.
Warnings and Precautions
Symptoms suggestive of IBC can occur with other ailments, such as an infection of the breast. However, due to the aggressive nature of inflammatory breast cancer, it's important to seek immediate medical evaluation if you experience any symptoms that might be due to IBC. Early diagnosis and treatment offers the best chance for effective treatment of IBC.
Reviewed and revised by: Tina M. St. John, M.D.