Breast Cancer (Inflammatory Carcinoma of the Breast)

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What is Breast Cancer?

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Inflammatory breast cancer is a rare and aggressive form of invasive breast cancer, where the skin of the breast becomes red, inflamed and pitted in appearance.

Who gets Breast Cancer?

Inflammatory breast cancer is one of the rarest types of breast cancer. Overall, inflammatory breast cancer makes up between 1-5% of all breast cancer cases.

Predisposing Factors

The causes of inflammatory breast cancer are still not fully understood. Some factors that can increase risk of developing any type of breast cancer include the following:

Age: the risk of developing breast cancer increases with age.
A family history of breast cancer in a first-degree relative (eg. a parent, sibling or child) doubles or triples a woman's risk of developing the disease. About 5% of women with breast cancer carry one of the two breast cancer genes, BRCA1 or BRCA2. If a relative also carries the gene, she has an increased risk of developing breast cancer.
Women with early menarche (first menstrual period), late menopause, or a late first pregnancy are at increased risk.
Women who use oral contraceptives have a very small increase in their risk of developing breast cancer.
The use of postmenopausal oestrogen replacement therapy also appears to increase the risk modestly, especially after long term use (greater than 5 years). This risk disappears 2 years after stopping hormone therapy.
Environmental factors, such as diet, may play a role in causing or promoting the growth of breast cancers, but conclusive evidence about the effect of a particular diet (eg. one high in fats) is lacking.
Radiation exposure before the age of 30 is also thought to increase risk.

Progression

Inflammatory breast cancer is a special type of breast cancer which develops and spreads quite differently from other breast cancers. In most breast cancers, such as ductal or lobular carcinomas, the cancer cells grow and develop as a solid lump in the breast. Inflammatory breast cancer cells develop differently. Instead of as a lump, inflammatory cancer cells grow quickly in the narrow lymph vessels of the breast, spreading along and blocking the flow of lymph. (The lymph vessels are part of the lymphatic system, which is responsible for collecting and filtering out bacteria and any waste materials that accumulate in the body.) The blockage of the lymph vessels is what causes the red, swollen and inflamed appearance of the breast, such as in the image below.

Inflammatory Breast Cancer

The way the cancer cells grow is also important because it affects how quickly the cancer spreads. In other types of cancer, the cells must first multiply and develop the ability to 'invade' into the lymph vessels or blood vessels before they can spread elsewhere in the body. In inflammatory breast cancer, however, the cancer cells are already growing in the lymph vessels. This allows them to spread far more quickly to lymph nodes in the breast and other parts of the body. This spread is referred to as 'metastasis', and is a poor prognostic factor.

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