By Nancy Gay
Former America’s Next Top Model contestant Jael Strauss passed away this week from a rare, aggressive malignancy called inflammatory breast cancer. The 34-year-old reality star died two months after doctors diagnosed her with the disease. Her death has many people wondering what inflammatory breast cancer is and why it is typically not diagnosed until after it spread throughout the body. Moffitt Cancer Center breaks down the signs, symptoms and treatment options for inflammatory breast cancer.
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What is Inflammatory Breast Cancer?
Inflammatory breast cancer is a rare, aggressive form of cancer that infiltrates the breast skin and lymph vessels and often goes undetected by mammography and ultrasound. Despite its name, inflammatory breast cancer is not caused by inflammation. Instead, the term “inflammatory” refers to the appearance of the breasts, which may look red, swollen or undergo a change in skin texture. These signs are similar to an infection, injury or irritation that leads to increased blood flow and the buildup of white blood cells in the body’s tissues. However, when inflammatory breast cancer is present, these symptoms develop as cancer cells block lymph vessels in the breast skin.
Common inflammatory breast cancer symptoms include:
- Breast warmth
- Redness or rash that covers more than one-third of a breast
- Thickened breast skin with a texture that resembles an orange peel
- Nipple inversion, flattening or dimpling
- Nipple discharge (other than breast milk)
- Breast tenderness or itchiness
- Sudden breast asymmetry
- A bruise on a breast that doesn’t go away
- Swollen lymph nodes in the neck, near the collarbone or in the underarm areas
These symptoms can develop as “nests” of cancer cells accumulate under the skin and clog the lymph system. Being aware of breast changes and understanding the risk factors are vital to discovering the cancer when the likelihood of successful treatment is highest. It is important for all women to become familiar with how their breasts look and feel, perform monthly self-exams and report anything unusual to a physician.
Who’s at Risk:
Inflammatory breast cancer is a rare, invasive type of cancer that accounts for about 1 to 5 percent of diagnosed breast cancers in the United States. Though it can strike anyone, it is associated with these risk factors:
- Gender – While inflammatory breast cancer can occur in men, women have a higher likelihood of developing the condition.
- Race – For reasons unknown, black women are at greater risk for inflammatory breast cancer than white women.
- Age – The average age at diagnosis of inflammatory breast cancer (52) is slightly lower than that of other forms of breast cancer (57).
- Body weight – Inflammatory breast cancer is more common among obese and overweight women than it is in women who maintain a healthy body weight.
- Genetics – A specific genetic risk for inflammatory breast cancer has not been found, but genetic factors that increase an individual’s risk for developing other types of cancer, such as the presence of BRCA1 (breast cancer gene one) or BRCA2 (breast cancer gene two), may also increase the risk of inflammatory breast cancer.
An inflammatory breast cancer diagnosis is usually confirmed after a woman or her physician has already noticed one or more of the typical symptoms. Because it usually presents as skin changes rather than a distinct lump or mass, a skin punch biopsy is often used to obtain a cell sample for further testing. If the biopsy results confirm the diagnosis of inflammatory breast cancer, a physician will likely order additional testing to determine the extent of the condition, whether the other breast is affected and whether lymph nodes or other organs are involved. Possible tests include:
- Breast MRI (magnetic resonance imaging)
- Chest X-ray
- CT scan (computerized tomography) of the chest, abdomen and pelvic area
- Bone scan
Inflammatory breast cancer is usually treated aggressively with pre-surgical chemotherapy, a mastectomy and post-mastectomy radiation therapy which is administered to the chest wall underneath the affected breast. Many experts believe that a modified radical mastectomy is more appropriate than breast-conserving surgery for several reasons:
- This aggressive form of breast cancer typically progresses very rapidly.
- The condition is often detected in an advanced stage.
- The cancer typically does not form a distinct lump or mass, so a lumpectomy is not possible. Instead, an entire breast and the surrounding lymph nodes will likely have to be removed in order to address all or most of the cancer.
Due to the extent of the cancer, a lumpectomy is not possible. Instead, an entire breast and the surrounding lymph nodes will likely have to be removed in order to address all or most of the cancer.
Though inflammatory breast cancer is difficult to find in the early stages, the bottom line is that all women should be familiar with how their breasts look and feel, perform monthly self-exams and report anything unusual to a physician. If you notice any changes, consult a physician immediately.