Inflammatory Breast Cancer
- Ellen Rabideau had received a clean mammogram in February 2021. But just weeks after her baby way born in May of that year, she started showing signs of her inflammatory breast cancer diagnosis.
- Inflammatory breast cancer (IBC) is an aggressive form of breast cancer. It is also rare and only accounts for 1 to 5 percent of all breast cancers, according to the American Cancer Society.
- The American Cancer Society (ACS) says women should begin yearly mammogram screening for breast cancer at age 45 if they are at average risk for breast cancer. The ACS also says those aged 40-44 have the option to start screening with a mammogram every year, and women age 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms.
- Risk factors for breast cancer include the following, according to one of our experts: being a woman, age, family history, having had a prior biopsy on an abnormal area, radiation exposure, lifetime estrogen exposure, not having a child before age 30 or never having children, obesity, drinking alcohol and lack of exercise.
Ellen had a clean mammogram in February 2021. She then gave birth to her 1-year-old girl, Tatum, at 37 weeks on Mother’s Day of that same year. But just weeks later, Ellen grew concerned when her baby stopped latching during breastfeeding.
Read More"Inflammatory breast cancer is incredibly rare and aggressive, and there is never usually a lump to be found," Rabideau said. “They do think this may have started growing while I was pregnant, and so I really think that [Tatum] coming early was the start of getting this ball rolling and finding my diagnosis.”
Rabideau is now thankfully in remission. And she’s even more grateful for her current state given that her maternal aunts died of breast cancer when they were in their 40s.
“Six months prior to her diagnosis, there was what we call a practice-changing study that released data that showed that using these PARP inhibitor drugs in BRACA-mutated patients gives better outcomes, so I was able to at least provide her with that information to say we have a better chance Ellen, your story is going to be different than every other family member in your family,” Rabideau’s doctor said.
This doctor also happens to be the same doctor that treated Rabideau’s aunts.
“To kind of rewrite the story for our family is, I feel, I feel really lucky,” Rabideau said.
Learning about Inflammatory Breast Cancer (IBC)
Inflammatory breast cancer (IBC) is an aggressive form of breast cancer. It is also rare and only accounts for 1 to 5 percent of all breast cancers, according to the American Cancer Society.
IBC causes a number of signs and symptoms, most of which develop quickly (within 3-6 months). IBC causes symptoms of breast inflammation, which is caused by cancer cells blocking lymph vessels in the skin leading to the breast looking “inflamed.” Below are some signs to look out for:
- Swelling (edema) of the skin of the breast
- Redness involving more than one-third of the breast
- Pitting or thickening of the skin of the breast so that it may look and feel like an orange peel
- A retracted or inverted nipple
- One breast looking larger than the other because of swelling
- One breast feeling warmer and heavier than the other
- A breast that may be tender, painful or itchy
- Swelling of the lymph nodes under the arms or near the collarbone
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And like other potential signs of cancer, if you do have exhibit any of these symptoms, it does not necessarily mean that you have IBC. Still, you should see a doctor promptly since IBC grows and spreads quickly.
All IBCs start as stage III, like in the case of Ellen Rabideau, since they involve the skin. But if the cancer has spread outside the breast to distant areas, it is considered stage IV.
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Treatment for IBC typically involves chemotherapy to try to shrink the tumor followed by surgery to remove the cancer. But radiation and other treatments like more chemotherapy or a targeted drug may also be given after surgery.
If the IBC is stage IV, treatment typically involves chemotherapy, hormone therapy, and/or targeted drugs.
The Importance of Screening
Screening for breast cancer is typically done via mammogram, which looks for lumps in the breast tissue and signs of cancer. The American Cancer Society (ACS) says women should begin yearly mammogram screening for breast cancer at age 45 if they are at average risk for breast cancer. The ACS also says those aged 40-44 have the option to start screening with a mammogram every year, and women age 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms.
For screening purposes, a woman is considered to be at average risk if she doesn't have a personal history of breast cancer, a strong family history of breast cancer, a genetic mutation known to increase risk of breast cancer such as a BRCA gene mutation or a medical history including chest radiation therapy before the age of 30. Beyond genetics, family history and experience with radiation therapy, experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
In a previous interview with SurvivorNet, Dr. Connie Lehman, chief of the Breast Imaging Division at Massachusetts General Hospital, said people who hadn't reached menopause yet should prioritize getting a mammogram every year.
When Should I Get a Mammogram?
"We know that cancers grow more rapidly in our younger patients, and having that annual mammogram can be lifesaving," Dr. Lehman said. "After menopause, it may be perfectly acceptable to reduce that frequency to every two years. But what I'm most concerned about is the women who haven't been in for a mammogram for two, three or four years, those women that have never had a mammogram. We all agree regular screening mammography saves lives."
It's also important to be on top of self breast exams. If you ever feel a lump in your breast, you should be vigilant and speak with your doctor right away. Voicing your concerns as soon as you have them can lead to earlier cancer detection which, in turn, can lead to better outcomes.
Thinking about Your Breast Cancer Risk
The risk of developing breast cancer varies greatly from person to person, so it's important to discuss your specific risk level with your doctor. That being said, there are some important risk factors to keep in mind.
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In a previous interview with SurvivorNet, Dr. Comen laid out several risk factors for breast cancer including:
- Being a woman: Women are at a higher risk for breast cancer, though men can get the disease too.
- Age: "Breast cancer becomes increasingly more common as women age," Dr. Comen said.
- Family history: "Some people think that breast cancer is only inherited through genes on the mom's side,' Dr. Comen said. "But it can also be related to genetic mutations that could be found on the father's side."
- Having had a prior biopsy on an abnormal area: "There are different markers, that if a woman has had a biopsy, it's important that she talk to her doctor about whether those markers are lending themselves to an increased risk of breast cancer," Dr. Comen said. If you've had a biopsy that indicated atypical hyperplasia, for example, you are at an increased risk of breast cancer. Atypical hyperplasia isn't cancer, but it is a precancerous condition that describes an accumulation of abnormal cells in the milk ducts and lobules of the breast.
- Radiation exposure: Cancer survivors who've had radiation to their chest are at an increased risk of breast cancer.
- Lifetime estrogen exposure: "About 2/3 of breast cancer are driven by the hormone estrogen," Dr. Comen said. "So, that means if a woman has had her period at an early age and started to go through puberty at an early age, at seven, eight, nine, and potentially a later age of menopause, means that her lifetime of having had menstrual periods and being exposed to higher levels of estrogen is higher, and therefore her risk of breast cancer is slightly higher."
- Not having a child before age 30 or never having children
- Obesity
- Drinking alcohol
- Lack of exercise: "While there's more research to be done in this area, it looks like if a woman is not exercising, she may also increase her risk for breast cancer," Dr. Comen said.
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