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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|.
Find out how we produce our information|
This information is about a rare type of breast cancer called inflammatory breast cancer. Ideally it should 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, but grow along, and block, the tiny channels (lymph vessels) in the skin of the breast.
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, which drains fluid from tissues and collects and filters out bacteria and any waste materials from the body’s cells.
Symptoms often develop quite suddenly. The breast looks red and inflamed, and feels 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.
This is the most important test to find out if cancer is present. A small sample of tissue is taken from the breast and then examined under a microscope to check for signs of cancer. A local anaesthetic is sometimes used to numb the area before the biopsy is carried out. A biopsy may also be taken from the lymph nodes under the arm to see if any cancer cells are present.
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 make up a picture of the breast tissue. It is done in the hospital’s scanning department. A special gel is spread onto the breast and then 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). Treatment often includes a combination of chemotherapy| , radiotherapy| , hormonal therapy| and surgery| . For most types of breast cancer, surgery is usually the first treatment. With inflammatory breast cancer, however, chemotherapy is usually 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. Chemotherapy helps to treat and control the disease in the breast, and reduce any swelling. As the chemotherapy travels all over the body, it will treat any cancer that may have spread beyond the breast to other parts of the body.
Following chemotherapy, most women have surgery. Usually the whole breast is removed (a mastectomy| ). But sometimes it is possible to have just the part of the breast that is affected 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.
After surgery, you may have radiotherapy and hormonal therapy to help reduce the risk of the cancer coming back.
Some breast cancer cells have oestrogen receptors on their surface. 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 a hormonal therapy to counteract the effects of oestrogen. There are different types of hormonal therapy, and they work in slightly 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.
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 after chemotherapy and surgery.
Herceptin| is one of a new group of drugs called monoclonal antibodies. Some breast cells divide and grow when a protein, human epidermal growth factor, attaches itself to another protein called HER2| . Herceptin blocks this process by attaching itself to the HER2 protein so that the epidermal growth factor cannot reach the breast cancer cells.
Some breast cancers have a lot more HER2 receptors on the cancer cells than normal. These breast cancers are described as HER2-positive. Herceptin only works in people who have HER2-positive breast cancer. Over half (about 60%) of people diagnosed with inflammatory breast cancer are HER2-positive.
Research into treatments for inflammatory breast cancer is ongoing, and advances are constantly being made. Cancer doctors use clinical trials| to assess new treatments. Before any trial is allowed to take place, an ethics committee must have approved it and agreed that the trial is 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 withdraw from a trial at any stage.You will 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 service nurses. Close friends and family members can also offer support.
This section has been compiled using information from a number of reliable sources, including:
We revise our fact sheets every year; the next edition will be available in January 2011.
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