There is a little known but deadly breast cancer that presents itself without a lump, so most women do not know how to check for the signs. It is cunning because it looks like a common, everyday irritation when it’s in the early stages, and it can progress to Stage IV in a matter of weeks or months. Many doctors see this cancer and mistake it for a spider bite, an allergic rash, or a mild infection.
Inflammatory breast cancer is a rare and aggressive disease. It strikes black women disproportionately, and doesn’t discriminate against the young. The average woman who gets this diagnosis is 57, but it’s seen in teenagers, as well. It kills young people more visciously than the rest: the trend is that younger patients commonly fail to survive five years after treatment. Perhaps they are less likely to seek treatment as soon as older women. But this disease can kill a woman stone dead in a matter of months without treatment.
Update: Photobucket removed the pictures of this disease, probably because they contain breasts. Great. Look in the links and the videos, and you will see many good photos of this disease’s various expressions.
Inflammatory breast cancer [IBC] is a genetically distinct form of breast cancer that behaves differently than those we learn to look for in breast self-exams. This disease is rare, but it is deadly. It accounts for 1%-5% of breast cancer diagnoses every year, but claims 25% of those who die of the disease overall.
Because IBC is so rare, many doctors have never seen a case in the early stages, and it’s too late before anyone realizes that the original signs were serious. It’s early manifestions look innocuous. The deadly lesion in the first photograph in this link looks like a mosquito bite or mild dermatitis. Perhaps it will look like mastitis or persistent bruising when it’s a little more advanced, but the progression varies significantly from patient to patient. IBC can only be recognized by eye, and then diagnosed with a biopsy. Mammogram and ultrasound are not good tools for probing this cancer. MRI is helpful, and there is ongoing research to develop PET techniques that are effective in identifying affected lymph modes and metastatis sites for this disease. But the primary diagnostic tool for this disease is the eye’s sense for subtle changes or irritations in the breast.
IBC has a perversely high metastatic potential, and it doesn’t localize into a lump. It spreads in nets through lymph channels in the skin on the breast, which is why the earliest symptoms are itching and redness or rash. Typical early symptoms are heaviness, burning, aching, increase in breast size, and tenderness. The symptoms develop quickly — sometimes in a matter of days or weeks — and swollen lymph nodes may or may not appear right away.
As the cancer progresses, the breast swells, and the nipple often flattens or inverts as in the second photo from this small clinical gallery provided by IBC Research Foundation. The mark at 11:00 over the nipple is a biopsy scar and not cancer, but be sure to note the characteristic rash under the breast. It is called peau d’orange, because it has dimples and a texture like an orange rind — a common symptom of IBC.
It’s rare to get mastitis if you are not breastfeeding. If you show signs of a breast infection — particularly without accompanying fever — see a doctor immediately.
The breast might get angry with a red or pink appearance and feel warm to the touch. It might also feel sore with persistant itching or burning, or be tender to the touch. In most cases, the breast enlarges beyond what is expected by normal hormonal changes, but that doesn’t have to happen. Sometimes the nipple will crust over or drain a bit of fluid. The important thing to know is that many women have only a subset of the symptoms, and that subset varies from case to case. The first photo in Journal of the America Academy of Physician Assistants shows another characteristic presentation of IBC. Here the breast is enlarged, inflamed, and covered with peau d’orange, but the nipple isn’t entirely inverted — it’s flattened a bit compared to the other, but not inverted.
It’s essential to look at photo galleries of the different ways this disease manifests and get a feeling for how it looks. Most importantly, get used to how your breasts look — and be sure to look underneath, as well. The woman in the clinical photo from the IBC Foundation gallery wouldn’t be able to see her IBC rash without a mirror.
Sometimes the only significant early symptom is an increase in size or weight of the breast. Yvette Hudgins tells her story:
Forty-five year old Yvette Hudgins has inflammatory breast cancer. She was diagnosed after noticing one of her breasts was suddenly larger than the other. “I just thought it was inflammation. I would never, ever have thought in a million years it was breast cancer,” says Hudgins. “I thought at first, maybe it’s just a little change but then it just progressed so I made an appointment with my doctor.”
The sad truth is that most women do not know about this type of breast cancer, and they are lulled into a false sense of security because they check for lumps every month, and they get a mammogram from time to time. They don’t know to screen for this disease — and their own eyes are the very best screening tools known for this in today’s technology. But one thing is certain: if one of these symptoms appears, there is no time to lose.
KOMO news did a segment on IBC a few years ago, and found that very few women were aware that there was a breast cancer that could manifest without a lump. They certainly didn’t know what to look for — until they were already diagnosed with a late stage cancer. Kristine Turck noticed that one of her nipples retracted a bit during the summer of 2003, but at the time, she’d never heard of IBC, and she didn’t know that this was a sign that she had a disease that would kill her. She spent the rest of her life trying to raise awareness about IBC. She passed away in 2007. She appears in the following piece about inflammatory breast cancer. Please watch this video at least once — the information in it could save a life.