This document is NOT intended to provide you with medical advice.  You should consult qualified practitioners in your area for such information. 

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• There is "regular" breast cancer and it progresses to the point where there it develops the characteristic "peau d'orange" with inflammation (more about that later). This manifestation has a primary tumor just like "regular" breast cancer and all of the other possibilities of "regular" breast cancer in addition to the IBC issues we'll address later in this Patients' Perspective.
• There is no identifiable primary tumor. Sometimes this is described as "diffuse" and sometimes it's described as "no identifiable primary". In either case, the only symptoms may be the characteristic peau d'orange with inflammation. Many times this combination is diagnosed as mastitis and the patient is started off on a seven-day course of antibiotics. The inflammation does not resolve or even mildly improve by the end of the week and, unfortunately, primary care physicians see so few cases of IBC over the lifetime of their practice that they do not recognize the symptoms of IBC. So, a different kind of antibiotic is tried for another week. Typically, we've found this may go on for a month or more before the there's a decision that it's not mastitis and the patient is directed to a breast care specialist.

Another characteristic is that the surface of the skin will appear inflammed in general. The inflammation may be range from bright red to dark purpley red such that some women think they've accidentally bruised themselves, except for the fact that the initial appearance is purpley rather than the typical blue color of a bruise followed by a gradual change to purple and then yellow as a bruise would heal.

The third characteristic is that surface temperature of the skin literally is a couple of degrees higher than skin in the area around the inflammation or on the other breast. A handy way to confirm this is to put one hand on the breast that seems to be inflammed and the other on your abdomen or other breast. If you sense a difference in temperature, that's a signal to alert your physician to the possibility of IBC.

Until there's a biopsy or surgery to get a pathology report, patients who are thought to have IBC from external clinical examination are staged as Stage IIIb unless they have identifiable metastatic disease at the time of diagnosis in which case they're staged at Stage IV. In any case, the best diagnosis for IBC is that it is considered to be locally advanced disease due to the presence of peau d'orange on the skin surface.

The only way the IBC diagnosis can be absolutely confirmed is through biopsy and/or surgery so that there is a pathology report to provide the confirmation.

Many oncologists consider that a patient with IBC, regardless of any other characteristics of the tumor such as ploidy, estrogen-receptor, S-phase, or her-2 overexpression, has an aggressive form of breast cancer and treats the patient with the biggest hammer available. In the US today, many oncologists consider that the biggest hammer is considered to be high-dose chemotherapy with stem cell rescue, though other, presumably less aggressive, treatments are available and have been used successfully for some patients.

Where to find out more about:
Inflammatory breast cancer

You can also learn more about inflammatory breast cancer from the National Cancer Institute's web site.

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