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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
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This information is about a rare type of breast cancer called inflammatory breast cancer. It should ideally be read with our general information about breast cancer|.
In inflammatory breast cancer, the cancer cells| may not grow as a lump that can be felt in the breast. They grow along the tiny channels (lymph vessels) in the skin of the breast, which blocks them.
The body reacts to the cancer cells in the lymph vessels and the breast becomes inflamed and swollen (which is how the condition gets its name). Lymph vessels are part of the lymphatic system|. They drain fluid from tissues and collect and filter out bacteria and any waste materials from the body’s cells.
Symptoms often develop quite suddenly. The breast| looks red and inflamed and feels firm, warm and swollen. Ridges or raised marks may appear on the skin of the breast, or the skin may look pitted, like the peel of an orange (known as peau d’orange).
Other symptoms may include a lump or thickening in the breast, pain in the breast or nipple, or a fluid (discharge) leaking from the nipple.
The appearance of the breast may suggest the diagnosis to your doctor. Certain tests will be needed to help make the diagnosis definite and to find out whether the cancer has spread.
Mammograms| may be used to look for changes in the affected breast and to check the other breast.
In this test sound waves are used to produce a picture of the breast tissue. A gel is spread onto the breast and a small device like a microphone, which emits sound waves, is rubbed over the area. The sound waves are converted into a picture using a computer. The test is completely painless and takes 5–10 minutes.
Inflammatory breast cancer can spread more quickly than other types of breast cancer, so treatment is often started straight away. You are likely to be offered a combination of different treatments that treat both the body as a whole (systemic treatment) and the breast area individually (local treatment).
Usually a combination of treatments are used. These may include: chemotherapy|, surgery|, radiotherapy|, biological therapy| and hormonal therapy|. For most types of breast cancer, surgery is usually the first treatment. But, with inflammatory breast cancer, chemotherapy is given first. Giving chemotherapy before surgery is known as neo-adjuvant treatment.
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It helps treat and control the disease in the breast and reduces swelling. As the chemotherapy travels around the body, it treats any cancer that may have spread beyond the breast to other parts of the body.
Chemotherapy for inflammatory breast cancer is often given for about 4-6 months. A combination of two or more chemotherapy drugs| are usually given.
Following chemotherapy, most women have surgery. Usually the whole breast is removed (a mastectomy|). But, sometimes just the part of the breast that is affected is removed (a wide local excision|). This depends on how well the cancer has responded to the chemotherapy, and the size and position of the tumour.
Radiotherapy| uses high-energy x-rays to destroy cancer cells, while doing as little harm as possible to normal cells. It may be given to the breast area to help reduce the risk of the cancer coming back.
Biological therapies are drugs that recognise and lock onto specific proteins (receptors) that are present in particular cancer cells. There are different types of biological therapies that work in slightly different ways.
More than half of women with inflammatory breast cancer (about 60%) have cancer cells that have a large amount of a protein called HER2| on their surfaces. This is called HER2 positive breast cancer|. The doctors will do tests to find out whether you have this type of breast cancer.
There are treatments specifically designed to treat HER2 positive breast cancer. The most widely used is trastuzumab (Herceptin®|). It works by locking onto the HER2 on the cancer cells so they can't be stimulated to grow.
Herceptin is given as a drip into a vein (intravenous infusion). It can be given with or after chemotherapy. It may also be given after breast cancer surgery, once a month for a year.
Another treatment that may be used to treat HER2 positive breast cancer is a tablet called lapatinib|. This works in a different way from Herceptin. It's a newer drug and is most likely to be given within a clinical trial.
Some breast cancer cells have oestrogen receptors on their surfaces. This is known as oestrogen receptor positive (ER+) breast cancer. This means that the cells rely on the hormone oestrogen to grow. Oestrogen is a female hormone that is naturally produced in the body.
If you have ER+ breast cancer, you'll be prescribed hormonal therapy to counteract the effects of oestrogen. There are different types of hormonal therapy that work in different ways. Some hormonal therapies reduce the amount of oestrogen made by the body. Others stop oestrogen from reaching the cancer cells.
Your doctor or breast care nurse will give you more information about the hormonal therapy you will be taking and any possible side effects it may have.
Research into treatments for inflammatory breast cancer is ongoing. Cancer doctors use clinical trials| to assess new treatments. Before any trial is allowed to take place, an ethics committee must approve it and agree that it's in the interest of patients.
You may be invited to take part in a clinical trial. Your doctor must discuss the treatment with you so that you have a full understanding of the trial and what it involves. You may decide not to take part, or to withdraw from a trial at any stage. You'll then receive the best standard treatment available.
You may experience many different emotions|, including anxiety and fear. These are all normal reactions and are part of the process many people go through in trying to come to terms with their condition. You may find it helpful to talk things over with your doctor or nurse, or with one of our cancer support specialists|. Close friends and family members can also offer support.
This section has been compiled using information from a number of reliable sources, including:
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.