Inflammatory Breast Cancer

Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer. According to the National Cancer Institute, about 1-5% of all breast cancer cases in the United States are inflammatory breast cancers.

Inflammatory breast cancer usually starts with the reddening and swelling of the breast instead of a distinct lump. IBC tends to grow and spread quickly, with symptoms worsening within days or even hours. It’s important to recognize symptoms and seek prompt treatment. Although inflammatory breast cancer is a serious diagnosis, keep in mind that treatments today are better at controlling the disease than they used to be.

The average age at diagnosis for inflammatory breast cancer in the United States is 57 for white women and 52 for African American women. These ages are about 5 years younger than the average ages at diagnosis for other forms of breast cancer. According to the American Cancer Society, inflammatory breast cancer is more common in African American women. A 2008 study found that being overweight makes a person more likely to develop IBC. Like other forms of breast cancer, IBC can also affect men.

The medical experts for Inflammatory Breast Cancer are:

• Massimo Cristofanilli, M.D., Associate Professor of Medicine, Department of Breast Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX
• Thomas Buchholz, M.D., F.A.C.R.; Professor of Radiation Oncology; Chair, Department of Radiation Oncology; The University of Texas M.D. Anderson Cancer Center, Houston, TX

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ILC - Invasive Lobular Carcinoma

Invasive lobular carcinoma (ILC), sometimes called infiltrating lobular carcinoma, is the second most common type of breast cancer after invasive ductal carcinoma (cancer that begins in the milk-carrying ducts and spreads beyond it). According to the American Cancer Society, more than 180,000 women in the United States find out they have invasive breast cancer each year. About 10% of all invasive breast cancers are invasive lobular carcinomas. (About 80% are invasive ductal carcinomas.)

Invasive means that the cancer has “invaded” or spread to the surrounding breast tissues. Lobular means that the cancer began in the milk-producing lobules, which empty out into the ducts that carry milk to the nipple. Carcinoma refers to any cancer that begins in the skin or other tissues that cover internal organs — such as breast tissue. All together, “invasive lobular carcinoma” refers to cancer that has broken through the wall of the lobule and begun to invade the tissues of the breast. Over time, invasive lobular carcinoma can spread to the lymph nodes and possibly to other areas of the body.

Although invasive lobular carcinoma can affect women at any age, it is more common as women grow older. According to the American Cancer Society, about two-thirds of women are 55 or older when they are diagnosed with an invasive breast cancer. ILC tends to occur later in life than invasive ductal carcinoma — the early 60s as opposed to the mid- to late 50s.

Some research has suggested that the use of hormone replacement therapy during and after menopause can increase the risk of ILC.

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LCIS - Lobular Carcinoma In Situ

Lobular carcinoma in situ (LCIS) is an area (or areas) of abnormal cell growth that increases a person’s risk of developing invasive breast cancer later on in life. Lobular means that the abnormal cells start growing in the lobules, the milk-producing glands at the end of breast ducts. Carcinoma refers to any cancer that begins in the skin or other tissues that cover internal organs — such as breast tissue. In situ or “in its original place” means that the abnormal growth remains inside the lobule and does not spread to surrounding tissues. People diagnosed with LCIS tend to have more than one lobule affected.

Despite the fact that its name includes the term “carcinoma,” LCIS is not a true breast cancer. Rather, LCIS is an indication that a person is at higher-than-average risk for getting breast cancer at some point in the future. For this reason, some experts prefer the term “lobular neoplasia” instead of “lobular carcinoma.” A neoplasia is a collection of abnormal cells.

LCIS is usually diagnosed before menopause, most often between the ages of 40 and 50. Less than 10% of women diagnosed with LCIS have already gone through menopause. LCIS is extremely uncommon in men.

LCIS is viewed as an uncommon condition, but we don’t know exactly how many people are affected. That’s because LCIS does not cause symptoms and usually does not show up on a mammogram. It tends to be diagnosed as a result of a biopsy performed on the breast for some other reason.

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Invasive Ductal Carcinoma (IDC) #Type of Invasive Breast Cancer.

Invasive ductal carcinoma

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Invasive ductal carcinoma (IDC), sometimes called infiltrating ductal carcinoma, is the most common type of breast cancer. About 80% of all breast cancers are invasive ductal carcinomas.

Invasive means that the cancer has “invaded” or spread to the surrounding breast tissues. Ductal means that the cancer began in the milk ducts, which are the “pipes” that carry milk from the milk-producing lobules to the nipple. Carcinoma refers to any cancer that begins in the skin or other tissues that cover internal organs — such as breast tissue. All together, “invasive ductal carcinoma” refers to cancer that has broken through the wall of the milk duct and begun to invade the tissues of the breast. Over time, invasive ductal carcinoma can spread to the lymph nodes and possibly to other areas of the body.

According to the American Cancer Society, more than 180,000 women in the United States find out they have invasive breast cancer each year. Most of them are diagnosed with invasive ductal carcinoma.

Although invasive ductal carcinoma can affect women at any age, it is more common as women grow older. According to the American Cancer Society, about two-thirds of women are 55 or older when they are diagnosed with an invasive breast cancer. Invasive ductal carcinoma also affects men.

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Ductal Carcinoma in situ (DCIS) #Type of Non-invasive Breast Cancer

Ductal carcinoma in situ (DCIS) is the most common type of non-invasive breast cancer. Ductal means that the cancer starts inside the milk ducts, carcinoma refers to any cancer that begins in the skin or other tissues (including breast tissue) that cover or line the internal organs, and in situ means "in its original place." DCIS is called "non-invasive" because it hasn’t spread beyond the milk duct into any normal surrounding breast tissue. DCIS isn’t life-threatening, but having DCIS can increase the risk of developing an invasive breast cancer later on.

When you have had DCIS, you are at higher risk for the cancer coming back or for developing a new breast cancer than a person who has never had breast cancer before. Most recurrences happen within the 5 to 10 years after initial diagnosis. The chances of a recurrence are under 30%.

Women who have breast-conserving surgery (lumpectomy) for DCIS without radiation therapy have about a 25% to 30% chance of having a recurrence at some point in the future. Including radiation therapy in the treatment plan after surgery drops the risk of recurrence to about 15%. Learn what additional steps you can take to lower your risk of a new breast cancer diagnosis or a recurrence in the Lower Your Risk section. If breast cancer does come back after earlier DCIS treatment, the recurrence is non-invasive (DCIS again) about half the time and invasive about half the time. (DCIS itself is NOT invasive.)

According to the American Cancer Society, about 60,000 cases of DCIS are diagnosed in the United States each year, accounting for about 1 out of every 5 new breast cancer cases.

There are two main reasons this number is so large and has been increasing over time:

• People are living much longer lives. As we grow older, our risk of breast cancer increases.
• More people are getting mammograms, and the quality of the mammograms has improved. With better screening, more cancers are being spotted early.

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Non-invasive & Invasive Breast Cancer.

Normal Cells

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Breast cancer usually begins either in the cells of the lobules, which are milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. The pathology report will tell you whether or not the cancer has spread outside the milk ducts or lobules of the breast where it started.

Non-invasive cancers stay within the milk ducts or lobules in the breast. They do not grow into or invade normal tissues within or beyond the breast.

Non-invasive cancers are sometimes called carcinoma in situ (“in the same place”) or pre-cancers. Invasive cancers do grow into normal, healthy tissues. Most breast cancers are invasive. Whether the cancer is non-invasive or invasive will determine your treatment choices and how you might respond to the treatments you receive.

Non-Invasive Cells

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Invasive Cells

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In some cases, a breast cancer may be both invasive and non-invasive. This means that part of the cancer has grown into normal tissue and part of the cancer has stayed inside the milk ducts or milk lobules. It would be treated as an invasive cancer.

A breast cancer also may be a “mixed tumor,” meaning that it contains a mixture of cancerous ductal cells and lobular cells. This type of cancer is also called “invasive mammary breast cancer” or “infiltrating mammary carcinoma.” It would be treated as a ductal carcinoma.

If there is more than one tumor in the breast, the breast cancer is described as either multifocal or multicentric. In multifocal breast cancer, all of the tumors arise from the original tumor, and they are usually in the same section of the breast. If the cancer is multicentric, it means that all of the tumors formed separately, and they are often in different areas of the breast.

In most cases, you can expect the breast cancer to be classified as one of the following.

• DCIS (Ductal Carcinoma In Situ): DCIS is a non-invasive cancer that stays inside the milk duct.
• LCIS (Lobular Carcinoma In Situ): LCIS is an overgrowth of cells that stay inside the lobule. It is not a true cancer; rather, it is a warning sign of an increased risk for developing an invasive cancer in the future in either breast.
• IDC (Invasive Ductal Carcinoma): The most common type of breast cancer, invasive ductal carcinoma begins in the milk duct but has grown into the surrounding normal tissue inside the breast.
• Less Common Subtypes of Invasive Ductal Carcinomacan include tubular, medullary, mucinous, papillary, and cribriform carcinomas of the breast. In these cancers, the cells can look and behave somewhat differently than invasive ductal carcinoma cells usually do.
• ILC (Invasive Lobular Carcinoma): ILC starts inside the lobule but grows into the surrounding normal tissue inside the breast.
• Inflammatory Breast Cancer: Inflammatory breast cancer is a fast-growing form of breast cancer that usually starts with the reddening and swelling of the breast, instead of a distinct lump.
• Male Breast Cancer: Breast cancer in men is rare, but when it occurs, it is almost always a ductal carcinoma.
• Paget’s Disease of the Nipple: Paget’s disease of the nipple is a rare form of breast cancer in which cancer cells collect in or around the nipple.
• Phyllodes Tumors of the Breast: Phyllodes tumors are rare breast tumors that begin in the connective tissue of the breast (stroma) and grow quickly in a leaflike pattern. Some are cancerous, but most are not.
• Recurrent and/or Metastatic Breast Cancer: Breast cancer that has returned after previous treatment or has spread beyond the breast to other parts of the body.

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Fitness Fights it #2

A new analysis has found that physical activity - either mild or intense and before or after menopause - may reduce breast cancer risk, but substantial weight gain may negate these benefits. Published early on FITNESS FIGHTS IT, the findings indicate that women can reduce their breast cancer risk by exercising and maintaining their weight. 

While studies have shown that physical activity reduces breast cancer risk, many questions remain. For example, how often, how long, and how intense does physical activity have to be to provide benefits? Also, do women with all body types experience a reduced risk when they exercise, and does exercise reduce the risk of all types of breast cancer? 

To investigate, Lauren McCullough, of the University of North Carolina Gillings School of Global Public Health in Chapel Hill, and her colleagues looked for a link between recreational physical activity, done at different time points in life, and the risk of developing breast cancer. 

The study included 1,504 women with breast cancer (233 noninvasive and 1,271 invasive) and 1,555 women without breast cancer who were 20 to 98 years old and were part of the Long Island Breast Cancer Study Project, an investigation of possible environmental causes of breast cancer. 

Women who exercised either during their reproductive or postmenopausal years had a reduced risk of developing breast cancer. Women who exercised 10 to 19 hours per week experienced the greatest benefit with an approximate 30% reduced risk. Risk reductions were observed at all levels of intensity, and exercise seemed to preferentially reduce the risk of hormone receptor positive breast cancer (ER or PR positive), which is the most commonly diagnosed tumor type among American women. 

"The observation of a reduced risk of breast cancer for women who engaged in exercise after menopause is particularly encouraging given the late age of onset for breast cancer," said McCullough. 

When the researchers looked at the joint effects of physical activity, weight gain, and body size, they found that even active women who gained a significant amount of weight - particularly after menopause - had an increased risk of developing breast cancer, indicating that weight gain can eliminate the beneficial effects of exercise on breast cancer risk. 


*Check next blog for Invasive and Noninvasive cancer.

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