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INFLAMMATORY BREAST CANCER

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Written by : Dr.M.D.Mazumdar, MD

Stages of Inflammatory Breast Cancer (IBC):

Like all cancers, inflammatory breast cancer is also staged according to the TNM classification, where T stands for the size of the tumor, N stands for the number of lymph nodes involved and M stands for Metastasis of the cancer cells.

Due to its aggressiveness and early metastasis, IBC is usually classified as either stage IIIB or stage IV breast cancer as soon as it is diagnosed.

Diagnosis of IBC:

  • Breast Biopsy : The main method of diagnosing inflammatory breast cancer is by breast biopsy. IBC is frequently misdiagnoised as a simple inflammatory condition of the breast known as mastitis , since the signs and symptoms are the same. The symptoms of IBC are not similar to the symptoms of other breast cancers like Invasive Ductal Cancer and Invasive Lobular cancer.

    • Punch Biopsy : If clinical examination causes suspicion of an inflammatory breast cancer, a skin punch biopsy is usually ordered. This is a type of biopsy in which a a circular tool is used to remove a small section of the skin and its deeper layers. The wound is then closed with stitches.

      Inflammatory Breast Cancer
      PUNCH BIOPSY

    • Core Needle Biopsy: If a specific mass or lesion can be identified, then an ultrasound guided core needle biopsy may be carried out. This procedure uses a somewhat larger needle with a sharp cutting edge. A core of tissue is cut from inside the mass. If the breast mass is quite large, as many as 15 samples, each about the size of a grain of rice, may be taken and sent to a lab for microscopic analysis.

  • Mammography : Mammographies are not very effective in identifying Inflammatory breast cancer. But the skin thickening may be detected on a mammogram.

  • Ultrasound of the breast : Ultrasound imaging, also known as ultrasonography or sonogram can also detect the skin thickening . But since skin thickening can occur in a number of other conditions like infections, it is not very diagnostic.

    Treatment of Inflammatory Breast Cancer:

    The biggest difference between treating IBC and other forms of breast cancer is that Chemotherapy is the first line of treatment, not surgery. Chemotherapy is started within a week or days of the diagnosis since the tumor is very aggressive and spreads fast. Chemotherapy helps in controlling the spread of the cells. <

    Chemotherapy also helps in shrinking the size of the tumor so that surgery can ensure complete removal of the cancerous cells. Radiotherapy may also be necessary after surgery.

    Treatment options for IBC include:

    • Chemotherapy: Medicines llike Adriamycin (chemical name: doxorubicin) or Ellence (chemical name: epirubicin) may be used. Another important chemotherapy medicine is Taxol (paclitaxel) .

    • Targetted therapy: If thE tissue sample tests positive for HER2 receptors, then medicines like Herceptin (chemical name: trastuzumab) may be used in addition to having chemotherapy.

    • Surgery: Surgery may consist of simple mastectomy if the tumor is caught at a very stage. But usually, radical mastectomy with removal of lypmh nodes (axillary lymph node dissection) needs to be carried out since inflammatory breast cancer invariably spreads to the lymph nodes before it is diagnosed. Surgery may be followed by chemotherapy or targetted therapy.

    • Radiation therapy: Radiation therapy may be needed if the inflammatory breast cancer does not respond to chemotherapy or tragetted therapy.

    See Page 1 for:

  • Symptoms of Inflammatory Breast Cancer



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