According to the National Cancer Institute (2012), “Inflammatory breast cancer can be difficult to diagnose. Often, there is no lump that can be felt during a physical exam or seen in a screening mammogram. In addition, most women diagnosed with inflammatory breast cancer have non-fatty (dense) breast tissue, which makes cancer detection in a screening mammogram more difficult. Also, because inflammatory breast cancer is so aggressive, it can arise between scheduled screening mammograms and progress quickly. The symptoms of inflammatory breast cancer may be mistaken for those of another form of locally advanced breast cancer or those of mastitis, which is an infection of the breast. [Editor's note: it is not unusual for a medical professional to prescribe antibiotics to rule out infection as a cause of symptoms. If no improvement is shown, tests to rule out IBC should be performed.]
“To help prevent delays in diagnosis and in choosing the best course of treatment, an international panel of experts published guidelines on how doctors can diagnose and stage inflammatory breast cancer correctly. Their recommendations are summarized below.
“Minimum criteria for a diagnosis of inflammatory breast cancer include the following:
- A rapid onset of erythema (redness), edema (swelling), and a peau d’orange appearance and/or abnormal breast warmth, with or without a lump that can be felt.
- The above-mentioned symptoms have been present for less than 6 months.
- The erythema covers at least a third of the breast.
- Initial biopsy samples from the affected breast show invasive carcinoma.
“Further examination of tissue from the affected breast should include testing to see if the cancer cells have hormone receptors (estrogen and progesterone receptors) or a mutation that causes them to make greater than normal amounts of the HER2 protein (HER2-positive breast cancer).
“Imaging and staging tests should include the following:
- A diagnostic mammogram and an ultrasound of the breast and regional (nearby) lymph nodes.
- A PET scan or a CT scan and a bone scan to see if the cancer has spread to other parts of the body.
“Proper diagnosis and staging of cancer helps doctors develop the best treatment plan and estimate the likely outcome of the disease, including the chances for recurrence and survival.”**
More information about tests and diagnosis of Inflammatory Breast Cancer
- NCCN Guidelines Breast Cancer Screening and Diagnosis® Version 1.2014
This is a 63 page, 881K pdf file available to download. Of particular interest to the IBC community is page 19 “Presenting Signs/Symptoms of Skin Changes,” shown in a decision tree format. There is an extensive “Discussion” of screening and diagnosis section, and on page 51 is discussion of skin changes and Inflammatory Breast Cancer.
- American Cancer Society “How is IBC diagnosed?”
- Mayo Clinic IBC tests and diagnosis
**Citation: Inflammatory Breast Cancer Questions and Answers Sheet. National Cancer Institute at the National Institutes of Health. www.cancer.gov, 2012. Retrieved from Web 17 May 2013.