Inflammatory Breast Cancer

Medically Reviewed by Jabeen Begum, MD on June 25, 2024
Written by WebMD Editorial Contributors
7 min read

Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer that often appears as a rash or an irritated area of skin. 

When compared to other forms of the disease, inflammatory breast cancer:

  • Looks different -- often there are no lumps, but your breast might appear red, swollen, or inflamed
  • Is harder to diagnose -- it doesn’t show up well on a mammogram
  • Is more aggressive and spreads more quickly than other types
  • Tends to be diagnosed at a younger age, especially among Black women
  • Is more likely to affect women who aren't at a healthy weight
  • Is often further along (your doctor may call this locally advanced, meaning it has moved into nearby skin) when it’s diagnosed
  • Sometimes has spread past the breast (metastasized) when it’s diagnosed, which makes it harder to treat

Inflammatory breast cancer vs. mastitis

Mastitis and inflammatory breast cancer can cause similar symptoms, including breast pain, swelling, warmth, and redness, but they’re different conditions. Mastitis is an inflammation or infection in the breast. It can affect people of any age, but it’s most common among those who are breastfeeding. 

Because inflammatory breast cancer is rare and often affects people in their 40s or 50s, if you're younger and have these symptoms, your doctor might not think of inflammatory breast cancer right away and first think it’s mastitis. 

 

Unlike more common types of breast cancer, this type generally doesn’t show up as a lump. The disease grows as nests under the skin.

Symptoms of inflammatory breast cancer include:

  • Pain in the breast
  • Skin changes in the breast area. You may find pink or reddened areas, often with the texture and thickness of an orange.
  • A bruise on the breast that doesn't go away
  • Sudden swelling of the breast
  • Itching of the breast
  • Nipple changes or discharge
  • Swelling of the lymph nodes under the arm or in the neck

These changes often happen quickly, over a period of weeks.

If you’re diagnosed with inflammatory breast cancer, you may have had a rash on your breast early on but not realized that it was something more than just a skin rash.

How an early inflammatory breast cancer rash looks depends on your skin color and tone. People with darker skin may have a dark or purplish rash, for example, while those with lighter skin may see pink or red rash. There may also be an orange-peel texture to the rash. Sometimes the rash might just look like a small insect bite or even a bruise, but it doesn’t fade away.

An important thing to note about a rash from early inflammatory breast cancer is that it appears and spreads very quickly. Usually it’s over a few weeks, but it can be as fast as a few days or hours.

This type of cancer is usually in one of three stages:

  • Stage IIIB: All Inflammatory breast cancers start in this stage since they involve the skin of your breast.
  • Stage IIIC: This cancer has spread to lymph nodes around your collarbone or inside your chest.
  • Stage IV: The cancer has spread outside your breast and nearby lymph nodes to other parts of your body.

Doctors don’t completely understand what causes inflammatory breast cancer to start. They do know that abnormal cells develop in the milk ducts and grow and divide. This is why most inflammatory breast cancers are considered to be invasive ductal carcinoma. 

The growing abnormal cells block the lymph vessels in your breast, which means that lymphatic fluid (fluid that drains cells and tissues from your body) can’t flow out of the breast. 

Once these ducts become blocked, that part of your breast can become red and swollen.

Anyone can develop inflammatory breast cancer, but some people are at higher risk of the disease. They include people who:

  • Are women or assigned female at birth
  • Are in their 40s and 50s
  • Are Black
  • Have obesity

If you have swelling or redness on your breast that doesn’t go away and doesn’t get better with antibiotics after a week, your doctor may suspect inflammatory breast cancer. Imaging tests will give a more detailed look at your breast. Your doctor may order one or more of the following:

  • Mammogram. Mammograms provide X-rays images of your breast and can show if the affected breast is denser or if the skin is thicker than the other breast.
  • MRI. Magnetic resonance imaging uses powerful magnets and radio waves to make pictures of the breast and structures inside your body.
  • CT scan. Computed tomography is a powerful X-ray that makes detailed pictures inside your body.
  • PET scan. A positive emission tomography scan, used together with a CT scan, can help find cancer in lymph nodes and other areas of the body.
  • Breast ultrasound. Ultrasound uses sound waves to create a picture of the inside of your breast. It can help spot changes that don’t show up on mammograms.

If the imaging tests show that you may have cancer, the next step is a biopsy. A doctor removes a small section of breast tissue or skin so it can be examined in a lab for cancer cells.

Often, the sample can be taken with a needle, but sometimes an incision (cut) is made to remove it. The type of biopsy you have may depends on whether a mass can be seen on imaging tests.

The medical team will look for any abnormal cell growth in the biopsy and also test for proteins associated with some cancers. If you’re diagnosed with inflammatory breast cancer, more tests can show how much of the breast and the area around it is affected.

Because inflammatory breast cancer spreads quickly, you’ll need an aggressive treatment plan. It may include:

  • Chemotherapy. This drug treatment is usually given before surgery to shrink the tumor so a surgeon can remove it. Chemotherapy also lowers the chance the cancer will come back.
  • Surgery. A mastectomy may be performed after chemotherapy. This procedure removes all of your breast.
  • Targeted therapy. If the cancer cells have too much of a protein called HER2, you may be given drugs specifically for that.
  • Hormone therapy. Certain medications may be given if the cancer cells have hormone receptors. These medicines block the receptors so they can’t attach to the hormones.
  • Radiation. Often, radiation treatments are given after chemotherapy and surgery to lower the chance of the cancer coming back.
  • Immunotherapy. These drugs use your immune system to help fight cancer. You might get them for advanced types of inflammatory breast cancer.

If you're interested in taking part in a clinical trial, ask your doctor. Clinical trials test new drugs to see if they're safe and if they work, or drugs that are already used but in different doses and combinations to see if they'll work better. They’re often a way for people to try new medicine that isn't available to everyone yet. Your doctor may be able to find a trial that might be a good fit for you.

Inflammatory breast cancer is aggressive and is likely to have spread by the time it’s discovered. It’s also more likely to come back than other types. Still, every case of cancer is unique. Your outlook depends on many things, like your overall health, the stage at which you were diagnosed, the treatment you got, and how your body responded to it.

The 5-year relative survival rate for people with inflammatory breast cancer in the U.S. is about 40%. 

How you will do depends on many things, including how advanced your cancer is, the available treatments, and your general health.

Unfortunately, there are no steps you can take to prevent inflammatory breast cancer from developing. And the traditional ways of detecting breast cancer overall (regular mammograms and self-examination) don’t always detect this type of cancer.

Inflammatory breast cancer is a rare form of breast cancer and it’s hard to detect in its early stages. If you develop sudden symptoms, such as a fast spreading rash, a bruise that doesn’t go away, and breast pain, see your doctor as soon as possible. Although these are also symptoms of mastitis, if you aren’t breastfeeding, it’s not likely to be mastitis. It could be inflammatory breast cancer.

Can inflammatory breast cancer be cured? Inflammatory breast cancer isn’t always curable, but it can be cured for many people. It depends on how early the breast cancer is diagnosed and treatment is started, and if you respond to the treatment. 

There is also a stage which isn’t quite a cure, but the cancer isn’t active. It’s not spreading as long as you take medication to keep it under control and the medication continues to work.

Does breastfeeding increase the risk of IBC? Some studies show that breastfeeding, especially over 1 year, may increase the risk of inflammatory breast cancer.

How fast does inflammatory breast cancer spread? Inflammatory breast cancer is a very fast moving form of cancer. It can spread in just a few weeks or months.

How to know that I have inflammatory breast cancer? The only way to know if you have inflammatory breast cancer is through testing and a biopsy, which will tell your doctor if there are cancer cells present and if so, what type of cancer you have.