‘Orange Peel’ Skin For Mom, 30, Turns Out To be Inflammatory Breast Cancer– Learn The Signs

Speaking to TODAY.com in a recent interview, with hopes of sharing her story to inspire others to get checked when something doesn’t seem right with their body, Franz explained, “I noticed a (breast) lump. It looked and felt like a silly putty shape and size, like that oval, and hard.”

Franz, who has no family history of breast cancer, suspected the lump wasn’t normal and decided to pay close attention to it. She even thought she might have had mastitis (inflammation of breast tissue that often affects women who breastfeed.

After seeking a doctor’s advice, she was told to get an ultrasound on November 10, 2020. She recounted to the news outlet, “They said, ‘Nope, it’s mastitis. This looks great. Here’s some antibiotics.’ They even sent me a letter saying, ‘You have no signs of cancer. Follow up in six months.'”

When Franz realized the medicine wasn’t helping, she said her breast’s appearance started to change.

She explained, “My breast started becoming very red and inflamed. I got what I later learned is ‘peau d’orange’ that looks like orange peel. I was like, ‘Something’s not right.'”

It wasn’t until Nov. 30 that she was told she had “at least” stage three inflammatory breast cancer. The diagnosis followed a second ultrasound and a biopsy.

Franz, who insists she had “no idea inflammatory breast cancer even existed” discovered soon after that her diagnosis was actually stage four.

According to MD Anderson, Franz’s tumor “responded well to treatment and she received her “very first no evidence of disease” on March 30, 2021.

“It felt amazing. We celebrate that day every year,” she told MD Anderson.

When Franz took her story to social media and revealed her diagnosis on Facebook, a friend contacted her suggesting she undergo treatment at MD Anderson.

Franz’s treatment consisted of at-home chemotherapy, as well as surgery to remove  her left breast 37 lymph nodes, following by six weeks of radiation.

She told TODAY.com, “They left me completely flat on one side and there was no option for implants. There’s typically not any option for reconstruction at all with inflammatory breast cancer because they have to do such a radical surgery taking so much skin.”

Following chemo, surgery, and radiation, Franz remains in remission and continues to get an infusion every three weeks to keep the cancer from returning. She also gets a scan every six months at MD Anderson.

As Franz copes with being a cancer survivor amid being a mom, she urges others to live life to the fullest, saying, “Your time is going quicker than you think, so plan the vacation. Do the thing. Spend time with the people who matter.”

Understanding Inflammatory Breast Cancer

Inflammatory breast cancer (IBC) is both a rare and aggressive form of breast cancer. This disease, which is a type of invasive ductal carcinoma, accounts for only 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

RELATED: You Should Be Aware of These Signs of Breast Cancer

And like other potential signs of cancer, if you do happen to notice any of these symptoms, it does not necessarily mean that you have IBC. However, you should still get checked by a doctor promptly since this type of breast cancer grows and spreads quickly.

All IBCs start as stage three since they involve the skin. But if the cancer has spread outside the breast to distant areas, it is considered stage four.

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 five, treatment typically involves chemotherapy, hormone therapy, and/or targeted drugs.

Learning About The “Skin Of An Orange” Breast Cancer Warning Sign

There are many possible indicators of breast cancer and they’re not as obvious as mass that you can feel. Olivia Franz experienced a “skin of an orange,” or peau d’orange, symptom, which refers to the skin on the surface of the breast having one or more dimples that resemble that of an orange peel. And while this may be an indicator of a very specific type of breast cancer called inflammatory breast cancer, Dr. Veronica Jones, Assistant Clinical Professor in the Division of Surgical Oncology, Department of Surgery at City of Hope, told SurvivorNet in a previous interview, it’s a very rare type of the disease to get.

“With peau d’orange, the breast becomes swollen, you have increased pore size and it looks like an orange peel when you have inflammatory breast cancer. But that is a very rare type of breast cancer, and that is not at all one of the most common signs of breast cancer,” she explained. “If you do see it, then absolutely go to your healthcare provider, but if you don’t see it, it doesn’t mean that you’re safe.”

RELATED: You Should Be Aware of These Signs of Breast Cancer

Inflammatory breast cancer is more likely to occur in younger women (the average age is 52, as opposed to 57 for other types of breast cancer) and is a particularly aggressive type of cancer.

Its unique symptoms, which usually come on quickly within 3-6 months, are caused by the cancer cells blocking the lymph vessels in the skin. However, as of 2009, it only occurred in approximately 1.6 out of every 100,000 women, according to an NIH study. 

Therefore, Dr. Jones warns there are other signs you should look for, as well, that may indicate other, more common types of breast cancers. And while a lot of people know to look for a lump, there are other, more subtle signs that may not be so obvious.

“Besides the mass, you’re looking for changes in skin such as redness, changes in the size of the breast, either increasing in size or decreasing in size, and changes in the nipple. Those are all signs that you should pay attention to and bring up with a healthcare provider.”

She explains further that if you notice the breast pulling inwards, you should be sure to mention it to a doctor, because potentially cancerous tumors can pull the tissue around it.

The biggest thing she recommends is to know what your breasts look like normally so you notice when something looks different because any change warrants a conversation with your doctor to rule out any issues.

The Importance of Breast Cancer 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.

RELATED: Terry Crew’ Wife, Breast Cancer Survivor Rebecca, Tells SurvivorNet: “I Am Thankful To Be Alive” & Says Mammogram Saved Her Life

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.”

RELATED: Check Your Breasts Today, and Once Every Month; Survivor Giuliana Rancic Stresses Its Importance

Itâ’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.

Symptoms of Breast Cancer

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. It’s also important to be on top of self breast exams.

Signs and symptoms of breast cancer may include:

• A breast lump or thickening that feels different from the surrounding tissue
• Change in the size, shape or appearance of a breast
• Changes to the skin over the breast, such as dimpling
• A newly inverted nipple
• Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
• Redness or pitting of the skin over your breast, like the skin of an orange

It’s important to keep an eye out for these symptoms while remembering that having one or many of them does not necessarily mean you have breast cancer.

Regardless, you should always speak with a doctor promptly if anything ever feels off or you’re experiencing one or more of the signs listed above. You never know when speaking up about your health can lead to a very important diagnosis.

What To Ask Your Doctor

If you have been diagnosed with breast cancer, you may have questions about keeping your strength through treatment. Here are a few questions to help you begin the conversation with your doctor:

• What treatment will I be receiving?
• What side effects are associated with this treatment?
• Are there steps I can take daily to help minimize these side effects?
• What physical activity routine do you recommend for me during treatment?
• Do you have recommendations for someone who doesn’t particularly enjoy exercise?
• Can you recommend a dietician who can help me with healthy eating tips and weight maintenance?
• I’ve been having trouble sleeping. Do you have any treatment recommendations?

Contributing: SurvivorNet Staff

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