What Are the Symptoms of Inflammatory Breast Cancer?

Inflammatory breast cancer is a rare special type of breast cancer. The tumor features are similar to the changes in acute inflammation. The breast is diffusely enlarged. The breast skin is red, swollen, hot, and painful. It is easy to be misdiagnosed as acute mastitis. About 50% of inflammatory breast cancers cannot detect the mass, and the pathological diagnosis is breast cancer. Most patients have metastases to the axillary and / or supraclavicular lymph nodes at diagnosis. The incidence of inflammatory breast cancer accounts for about 2.0% of all breast cancers. The average age of onset is 52 years. The course of disease progresses rapidly and the prognosis is poor. The incidence of metastasis is as high as 30% to 40%. The 5-year survival rate is only 25% to 48 %.

Basic Information

English name

inflammatory carcinoma

Visiting department

Oncology

Multiple groups

50 to 54 year old women

Common causes

May be related to patient's low immune level

Common symptoms

Diffuse breast enlargement, redness, swelling, heat, and pain in breast skin

Causes of inflammatory breast cancer

Inflammatory breast cancer is a type of breast cancer that progresses rapidly, has a high degree of malignancy, and has a poor prognosis. Its pathogenesis may be related to the patient's low immune level. The cause of breast cancer is not completely clear. Studies have found that women with high risk factors for breast cancer are susceptible to breast cancer. The high incidence of breast cancer in Chinese women by age group shows that it gradually rises after 25 years of age, reaches a peak in the 50-54 year old group, and gradually decreases after 55 years old. Family history of breast cancer is a risk factor for breast cancer. The so-called family history refers to patients with breast cancer among first-degree relatives (mother, daughter, and sister). In recent years, it has been found that dense breast glands have become a risk factor for breast cancer. Risk factors for breast cancer include early menarche (<12 years), late menopause (> 55 years); unmarried, unfertile, late fertility, and non-lactating; undiagnosed and diagnosed with benign breast diseases in a timely manner; biopsy (biopsy) by hospital Atypical breast hyperplasia has been confirmed; the chest has been exposed to high doses of radiation; long-term use of exogenous estrogen; postmenopausal obesity; long-term excessive drinking; and mutations associated with breast cancer. Women with several of these high risk factors have a higher risk of breast cancer than normal people.

Clinical manifestations of inflammatory breast cancer

The onset of inflammatory breast cancer is rapid and the course of the disease progresses rapidly. Because cancer cells spread to the subcutaneous lymphatic network, cancer plugs are formed, lymphatic return is blocked, capillaries are blocked and expanded, and a large amount of blood is congested. The breast skin is red, swollen, thickened, and hardened, with an orange peel-like appearance, which gradually turns into a purplish-red like bruise, and local skin may appear erysipelas-like changes or mottling pigmentation. The temperature of the affected skin increases. With the rapid enlargement of the breast, swelling, pain, and expansion of the lesion, the disease is very similar to acute mastitis. Toughness, firmness, tenderness, and borders of the tumor are unclear. Some patients had nipple cracking, crusting, retraction, and elevation. Swollen lymph nodes can be touched under the armpits.

Inflammatory breast cancer examination

1. Blood test (differentiated from mastitis).

2. Breast imaging examination, including mammography, color Doppler ultrasound and magnetic resonance examination. For suspected patients, chest and abdominal CT and whole-body bone scans should also be performed to provide a basis for further treatment.

3. Clear diagnosis by histopathology. The diagnosis can be confirmed by puncturing the breast or representative skin with sclerosis, edema, or redness. Surgical biopsy can be performed to obtain appropriate tumor tissues and affected skin and subcutaneous lymphatic tissues. Pathological examination is used to confirm the diagnosis.

Diagnosis of inflammatory breast cancer

According to the clinical manifestations, the breasts diffusely increase in a short time, the range often exceeds 1/3 of the entire breasts, become hard, tender, and the skin of the breasts is widely reddened, thickened, with an orange peel-like appearance, and the temperature of the diseased skin increases. Combined with mammography. X-ray of the mammary glands shows diffuse thickening of the skin and increased density, thickening and thickening of the subcutaneous tissues and parenchyma of the breast parenchyma, sometimes micro-calcifications and local masses, nipple retraction, and axillary lymph nodes. Ultrasound showed that the skin was thickened, the subcutaneous layer was thickened and there were linear liquid dark areas. The glandular layer generally did not have obvious mass images. It showed structural disturbances, weakened echoes, blurred borders, increased blood flow signals, and increased high speed. Obstructive arterial spectrum, mostly accompanied by axillary lymphadenopathy. Breast lesions were biopsied by puncture or surgery, and confirmed by histopathological examination.

Inflammatory breast cancer needs to be distinguished from acute mastitis and breast lymphoma. Acute mastitis usually occurs in lactating women, often accompanied by fever and increased white blood cells, antibiotic treatment is effective, puncture shows pus and necrotic tissue, and smears show inflammatory cells. Breast lymphoma, especially non-Hodgkin's lymphoma, has clinical manifestations like inflammatory breast cancer and can be identified by pathological histopathology.

Inflammatory breast cancer treatment

Patients with inflammatory breast cancer often have tumors that have spread and metastasized at the time of diagnosis. Simple local treatments such as surgery or radiation therapy have no effect on metastases, so the effect is poor. After years of clinical practice and research, it has been found that comprehensive treatment should be used to treat inflammatory breast cancer. First, neoadjuvant chemotherapy, that is, preoperative chemotherapy; for patients with inflammatory breast cancer with a positive HER-2 test, trastuzumab (targeted therapy) can also be used in combination with chemotherapy. Patients who achieved clinical remission with neoadjuvant chemotherapy should undergo surgery or radiotherapy after chemotherapy. Surgery is recommended for mastectomy and axillary lymph node dissection. Breast preservation surgery is not suitable for inflammatory breast cancer. Inflammatory breast cancer often has lymphatic obstruction and is not suitable for sentinel lymph node biopsy. Although some patients have a need for breast reconstruction during mastectomy, for patients with inflammatory breast cancer, immediate breast reconstruction should be performed with caution. Due to the higher risk of local and regional recurrence after inflammatory breast cancer, radiotherapy is routinely performed.

Research on high-dose chemotherapy plus peripheral blood stem cells supporting the treatment of inflammatory breast cancer has achieved encouraging results, but the greater toxicity and lower quality of life have made the above treatments not recommended for clinical use beyond clinical trials.

Inflammatory breast cancer prevention

Inflammatory breast cancer is a special type of breast cancer that can occur at any age just like other types of breast cancer. Prevention of inflammatory breast cancer is the same as general breast cancer. It is worth mentioning that patients with inflammatory breast cancer may be associated with low autoimmune function.

Because the cause of breast cancer is not fully understood, there is no exact way to prevent breast cancer. From the epidemiological analysis, the following aspects can be considered in the prevention of breast cancer:

1. Establish a good lifestyle, adjust the pace of life, and maintain a comfortable mood.

2. Insist on physical exercise, actively participate in social activities, avoid and reduce mental and psychological tension factors, and maintain a peaceful mindset.

3. Develop good eating habits.

4. Actively treat breast diseases.

5. Do not mess with exogenous estrogen.

6. No long-term excessive drinking.

Female friends are advised to understand the popular science knowledge of breast diseases, such as breast inflammation-like changes, you should be alert and seek medical treatment in a timely manner. Master the method of breast self-examination and develop the habit of regular breast self-examination. Actively participate in breast cancer screening.