Inflammatory breast cancer: sign, what is it, aggressive?

Among the types of breast cancer, There is inflammatory breast cancer who is rare (1 to 2% of all breast cancers) but aggressive because he is able to grow and spread very quickly. What are the signs inflammatory breast cancer? His causes of occurrence? His risk factors ? What exams allow you to put a diagnostic inflammatory breast cancer? How to treat it? Insight from Dr Florence Lerebours, oncologist at theCurie Institutespecialized in onco-senology for the treatment of breast cancer

What is inflammatory breast cancer?

“Breast cancer is said to be “inflammatory” because there are inflammatory signs on the skin of the breast (on more than a third of the breast): the breast has edema, is red with a orange peel appearance“, answers our interlocutor straight away. Inflammation is fastthat is to say, it evolves in less than 4 to 6 months. This type of cancer is exceptional, nevertheless it remains very aggressive, with a high risk of metastasis.

Figures: how many inflammatory breast cancers in France?

“Inflammatory breast cancer is between 1 and 2% of all breast cancers“, tells us Dr. Lerebours. The incidence of non-inflammatory breast cancers is relatively stable, while the incidence of inflammatory breast cancers is increasing slightly.

What causes inflammatory breast cancer?

“The cause of inflammatory breast cancer is not yet known. Risk factors are also unclear. Those that stand out the most in the studies are overweight and obesity. Also, through studies conducted by working groups, there seem to be areas in the world where there are more inflammatory breast cancers than probably elsewhere, to the point where a viral hypothesis had been imagined, which ultimately has not been demonstrated.“, explains Dr. Lerebours.

What are the symptoms of inflammatory breast cancer?

In inflammatory breast cancer, the skin of the breast is:

• more or less red
• often warm to the touch
• swollen, thick and padded like an orange peel (edema)
• sensitive and painful

Note that these inflammatory signs are visible on at least one third of the breast.

The diagnosis of inflammatory breast cancer is directed through clinical examinatione, the signs being visible to the naked eye. But beware, it is necessary to eliminate other types of inflammation such as there mastitis, whose symptoms (redness, edema of the skin of the breast) are close to those of an inflammatory breast cancer. “Then, imagery is done. mammography, ultrasound And MRI as well as’a breast biopsy (only the biopsy can make the diagnosis of cancer). In a number of cases, we also realize a skin biopsy. Indeed, international recommendations recommend also biopsying the skin to detect emboli (clusters) of cancer cells in the dermis, characteristics of inflammatory breast cancer“, she continues. Screening by mammography is essential to detect a possible tumor early, it must be remembered!

“We never operate on a tumor in full growth”

What is the treatment for inflammatory breast cancer?

In case of non-metastatic inflammatory breast cancerwe always start with chemotherapy (called neoadjuvant) sometimes with targeted therapy to be able to reduce the inflammation. If chemotherapy has reduced the size of the tumour, we can use surgery to remove the tumor. In this case, we remove completely the breast (mastectomy). “What you have to understand is that you never operate on a growing tumor. We are waiting to absorb it to be able to operate.“, wishes to remind Dr. Lerebours. After the surgery, we may have recourse to a chemotherapy (which is called adjuvant), to hormone therapy if the tumor is hormone sensitive and at a radiotherapywhich reduces the risk of cancer coming back in the area where the breast was removed. In case of metastatic inflammatory breast cancerwe do not operate and we treat the metastases medically.

What is the prognosis for survival of inflammatory breast cancer?

“Inflammatory breast cancer is much more aggressive than non-inflammatory breast cancer. Very often, it is found at a more advanced stage. At the time of diagnosis of inflammatory breast cancer, metastases are found in almost 1/3 of cases (compared to 10 to 15% in non-inflammatory breast cancers) so quickly has it evolved and disseminated elsewhere in the body. It is a cancer that responds less well to treatment. The 5-year survival for inflammatory breast cancer is around 40%, while the 5-year survival for all types of non-inflammatory breast cancer combined is around 85 to 90%.“, explains Dr. Lerebours. Remember, however, that the prognosis and survival of inflammatory breast cancer vary from one person to another, depending on the characteristics of each patient’s tumor, their response to treatment and their medical history.

Thanks to Dr Florence Lerebours, oncologist at the Institut Curie.