Breast Cancer

What Is Inflammatory Breast Cancer? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Julie Lynn Marks
By
Lisa D. Curcio, MD, FACS
by
Published on July 5, 2024
Inflammatory breast cancer (IBC) is a rare and aggressive type of breast cancer. It accounts for between 1 and 5 percent of all breast cancer cases in the United States.

With IBC, cancer cells block lymph vessels, which are small tubes that let lymph fluid drain out of your breast.

 It’s called “inflammatory” breast cancer because the breast appears inflamed and red due to this blockage.
IBC is often hard to spot because it doesn’t cause the classical symptoms that you might associate with breast cancer. For example, patients with IBC don’t usually have a signature breast lump that’s common in other types of breast cancer.

Though IBC is very fast-growing and often spreads throughout the body quickly, early diagnosis and treatment can help improve your outlook.

Signs and Symptoms of Inflammatory Breast Cancer

IBC doesn’t look like other types of breast cancer. Instead, it causes distinct symptoms that are often missed because they can mimic other conditions.

Some common signs and symptoms of IBC are:

  • Swelling, pain, firmness, heaviness, tenderness, or itchiness in one breast
  • Skin on your breast that appears red, purple, pink, or bruised
  • Unusual warmth or burning of the breast
  • Enlargement of one breast
  • Dimpled, pitted, or thickened skin on your breast, which looks like an orange peel
  • Nipples that retract inward or are flattened
  • Swollen lymph nodes under your arm or near your collarbone
Symptoms must usually be present for fewer than six months to be considered for an IBC diagnosis.

Is It IBC or Mastitis?

IBC is often confused with mastitis, which is a breast infection that often affects women who are breastfeeding. However, anyone can have mastitis. Some people develop this infection due to a cyst, an ingrown hair, or a blocked duct.

Mastitis can cause redness, warmth, thickness, and tenderness of the breast, just like IBC. But you may feel a lump if you have an abscess due to mastitis. Additionally, mastitis will usually go away when you take antibiotics.

If your symptoms don’t improve within 7 to 10 days of taking antibiotics, you might need more tests to check for cancer. Doctors may be more apt to consider IBC over an infection if you have symptoms and aren’t pregnant or breastfeeding.

Illustrative graphic titled Inflammatory Breast Cancer or Mastitis shows IBC: Swelling, inverted nipple, no lump, rare, diagnosed with a biopsy. Mastitis: fever/chills, nipple discharge, may feel a lump, common with breastfeeding and antibiotics
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Inflammatory Breast Cancer Causes and Risk Factors

Researchers haven’t identified the exact cause of IBC.

 They do know that IBC develops when cancer cells block lymph vessels, which normally help drain lymph fluid from your breast. Often, these cancer cells spread, or metastasize, from your lymph vessels to other organs in your body.

While anyone can develop IBC, you may be more likely to have this type of breast cancer if you are:

  • A Woman While IBC can also affect men, it’s more common in women.
  • Younger IBC tends to affect a younger population than other forms of breast cancer. The average age at diagnosis is 57.
  • Black People who are Black have a higher risk of developing IBC.
  • Overweight or Have Obesity Having a high body mass index (BMI) can raise your risk for IBC.

How Is Inflammatory Breast Cancer Diagnosed?

IBC is tricky to diagnose because it usually doesn’t show up as a lump on common screening tests, such as a mammogram.

 However, other methods that are available to help your doctor spot this type of cancer include:

  • Physical Exam Your doctor looks for signs of IBC, like swelling of one breast; skin changes, including what appears to be bruising; and thickening of the skin with more visible pores (called peau d’orange).
  • Imaging Tests A mammogram, magnetic resonance imaging (MRI) scan, or ultrasound can provide pictures of the inside of your breast. Though these imaging tests may not pick up a solid mass, they could detect abnormal spots or skin thickening.

     Unfortunately, breast infections and IBC often look similar on imaging tests.

  • Biopsy A biopsy involves taking a sample of tissue from your breast to examine in the lab under a microscope. It’s the only definitive way to confirm an IBC diagnosis.

After making a diagnosis, your doctor will stage your cancer. Staging helps you and your medical team determine the extent of the disease in your body and your treatment options. All IBCs start when they are in stage 3 since they involve the skin. If the cancer has spread to other organs in your body, it’s considered stage 4.

Prognosis for Inflammatory Breast Cancer

In general, patients with IBC don’t survive as long as those with other types of breast cancer.

Part of the problem is that IBC can grow fast, sometimes in a matter of weeks. By the time you’re diagnosed with this cancer, it has already spread to the skin. Also, IBC frequently comes back after treatment.

The five-year IBC survival rate is:

  • 52 percent for cancers that have reached the skin and/or lymph nodes
  • 19 percent for cancers that have spread to distant areas of the body, such as the lungs or liver
While these statistics may be helpful in determining your outlook, they are only estimates. The median overall survival for women with IBC is less than four years, but with improved cancer treatments, survival has increased in recent years.

 Some people with IBC live for many years after receiving a diagnosis.

Treatment Options for Inflammatory Breast Cancer

Your treatment options for IBC may depend on the stage of your cancer, the tumor biology, your overall health, and your goals. Often, different types of treatment are used together for a better result.

Chemotherapy

Chemotherapy involves using drugs to kill cancer cells in your body. The medicines can be administered through a vein using an IV or as pills taken by mouth.

Chemo may be used alone or with other treatments. It’s often given to shrink a tumor before surgery. Chemotherapy can also be used after surgery to wipe out any remaining cancer cells left on the chest wall or in the bloodstream.

Surgery

People with stage 3 IBC may be candidates for surgery. Surgical procedures are typically done after you’ve had chemotherapy.

Because IBC spreads so quickly, a lumpectomy, which only removes cancer and surrounding tissue, isn’t an effective option.

 Instead, doctors might recommend:
  • Mastectomy This is surgery to remove your entire breast.
  • Axillary Lymph Node Dissection This is surgery to remove the lymph nodes in your armpit and near your breast.
You may want to have a breast reconstruction procedure after your surgery. Your doctor can help you figure out the best time to have this operation.

Radiation

Radiation is a treatment that uses high-energy beams to destroy cancer cells on the chest wall or in the area around the lymph nodes in the armpit. When it comes to IBC, radiation is usually given after surgery to kill any cancer cells that may be left behind.

Targeted Therapy

Targeted treatments focus on specific proteins in cancer cells. For instance, these medicines can block a protein called human epidermal growth factor receptor 2 (HER2).

 If you test positive for HER2, your doctor may recommend a targeted treatment, such as trastuzumab (Herceptin). Targeted treatments can be used with other therapies, and they can be given before or after surgery.

Hormone Therapy

Some types of breast cancer feed off of the hormones estrogen and progesterone. If your IBC is hormone receptor–positive, hormone therapy may be a treatment option. These medicines prevent estrogen from binding to its receptor or block your body’s ability to make estrogen. Some examples are tamoxifen (Nolvadex) and letrozole (Femara).

Immunotherapy

Immunotherapy helps harness your body’s own immune system to fight cancer. It may be an option if your cancer has metastasized and also tests negative for hormones and the HER2 protein (also called triple-negative breast cancer).

 Researchers are still investigating how immunotherapy medicines can help people with IBC.

Clinical Trials

A clinical trial is a research study that tests the safety and effectiveness of new treatments. By participating in a clinical trial, you may receive a novel therapy that isn’t yet available otherwise. Your doctor can help you find a clinical trial that’s suitable for you.

Questions to Ask Your Doctor

  • What stage is my breast cancer?
  • What treatments do you recommend and why?
  • What are the possible side effects of those treatments?
  • What do you think my outlook will be if I have these treatments?
  • Should I see any other type of doctor or specialist?
  • How can I find out more about clinical trials for IBC?
  • Can you help me find support or other resources for coping with cancer?

Palliative Care

Palliative care is a type of care that helps you improve your quality of life by managing any pain or discomfort.

Some approaches used in palliative care include:

  • Pain-relieving medications
  • Relaxation exercises
  • Emotional and spiritual support
  • Nutritional counseling

Complementary and Integrative Therapies

Complementary and integrative therapies won’t cure your disease, but they could help you feel better. They may also ease treatment side effects. But it’s important to talk to your doctor before trying any new therapy.

Some common complementary approaches include:

  • Acupuncture
  • Aromatherapy
  • Exercise
  • Hypnosis
  • Journaling
  • Massage
  • Meditation
  • Music therapy
  • Relaxation techniques
  • Yoga or tai chi

Prevention of Inflammatory Breast Cancer

There’s no sure way to prevent IBC, but certain lifestyle habits may help you lower your risk. And spotting the cancer early could mean a better prognosis.

Some ways to help lower your risk or increase your odds for a more favorable outlook include the following:

  • See your doctor regularly for breast screenings and exams.
  • Become familiar with how your breasts look.
  • Avoid daily alcohol use.
  • Exercise for 30 minutes on most days of the week.
  • Maintain a healthy weight.
  • Limit the use of combination hormone replacement therapy during menopause.

Complications of Inflammatory Breast Cancer

IBC can cause complications, which are secondary health problems. Many of the complications associated with IBC happen as a result of the cancer metastasizing, or spreading. For example, cancer that travels to your bones can cause pain, neurological problems, kidney stones, confusion, memory issues, and arrhythmias. If it spreads to your liver, you may develop abdominal pain, nausea, vomiting, or jaundice. When IBC infiltrates the brain, it can cause headaches, vision problems, behavioral changes, and memory issues.

The treatment you receive for IBC can also prompt unwanted symptoms. Chemotherapy can cause nausea, diarrhea, and mouth sores. Radiation may trigger pain and scarring. Surgery can sometimes cause disfigurement. If you have your lymph nodes removed, you may experience lymphedema, which is a buildup of lymph fluid under your skin.

Research and Statistics: Who Has Inflammatory Breast Cancer?

About 310,720 new cases of invasive breast cancer are diagnosed each year in the United States.

 Only 1 to 5 percent of these are IBC.

Though IBC represents a very small number of breast cancers, it accounts for about 10 percent of breast cancer deaths.

IBC is most common in North Africa. It makes up 11 percent of all breast cancer cases in Egypt.

Disparities and Inequities in Inflammatory Breast Cancer

Research shows that Black women tend to develop IBC more often than white women.

 One study found the incidence of IBC among Black women was more than 70 percent higher than in white women.

Researchers are still trying to learn about why Black people are disproportionately affected. Some factors that may explain this disparity include:

  • Lack of awareness about the signs and symptoms of IBC
  • Biological or genetic differences
  • Environmental factors
  • Delays in diagnosis or treatment
  • Lower standard of care

Related Conditions

Some conditions closely related to IBC include:

  • Invasive ductal carcinoma (IDC). IDC is a type of breast cancer that happens when cancer cells grow outside the milk ducts of your breast. IBC is a type of IDC.

  • Metastatic breast cancer. This is breast cancer that has spread to another area of your body.
  • HER2-positive breast cancer. With this type, breast cancer cells have too much HER2 protein.
  • HER2-negative breast cancer. The breast cancer cells don’t contain the HER2 protein.
  • HER2-low breast cancer. Cancer cells make a low amount of HER2 protein.
  • Triple-negative breast cancer. These breast cancers don’t feed off of estrogen, progesterone, or HER2.
  • Ductal carcinoma in situ (DCIS). Some of the cells that line the milk ducts of the breast change to look like cancer cells.

Support for Inflammatory Breast Cancer

A diagnosis of IBC can be upsetting. Finding support may help you manage your emotions. You might want to join an in-person or online group. Talking to a mental health professional can also help.

Here are some organizations that offer support and resources for people battling IBC or other types of breast cancer:

The Takeaway

Inflammatory breast cancer is a rare, aggressive type of breast cancer. However, it can be curable if caught and treated early. Treatment usually starts with chemo and surgery, and may be followed by other types of therapy such as radiation, hormone therapy, targeted therapy, and immunotherapy. Be sure to speak to your doctor before starting any new treatments, including complementary and integrative therapies.

Common Questions & Answers

What are the first symptoms of inflammatory breast cancer?
The first signs of IBC are usually swelling, redness, and pain in your breast.
Who is most at risk for inflammatory breast cancer?
People who are most at risk for inflammatory breast cancer are women, Black people, individuals who are in their 40s or 50s, and those who are overweight or have obesity.
What is the survival rate of inflammatory breast cancer?
The five-year survival rate for IBC is 39 percent for all the stages combined. If the cancer has only spread to nearby structures, the survival rate is 52 percent. If the cancer has metastasized to other areas of your body, the survival rate is 19 percent.
How curable is inflammatory breast cancer?
IBC is one of the most aggressive types of breast cancer. However, it can be cured if it’s diagnosed early and treated quickly.

Resources We Trust

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

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