Is There Really a Breast Cancer Without a Lump?

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Until a few years ago, only a handful of physicians and nurses -- and an even smaller number of women in the community at large -- had ever heard of a rare but fast-growing type of breast cancer, inflammatory breast cancer (IBC).

The birth of the Internet provided a vehicle for mass communication unparalleled in our history. Perhaps, like me, you were the recipient of the first e-mail alert with a subject line of "the breast cancer without a lump: what every woman should know." That first alert was composed by the mother of a young woman in her 30s who was losing her battle with inflammatory breast cancer.

For decades, women have been lulled into a false sense of security when it comes to breast cancer. That is if you perform monthly self-checks and have an annual mammogram screening after age 40, you'll be able to catch breast cancer in its early stages. These are important guidelines that every woman should heed, but inflammatory breast cancer doesn't play by conventional rules. What about "the breast cancer without a lump"?

Inflammatory Breast CancerIBC is particularly aggressive. The five-year survival rate for IBC is only 40%. (The five-year survival rate for all breast cancers combined is 87%.) It occurs in relatively young women. It's not uncommon to see women in their 30s to 50s in our Inflammatory breast cancer Clinic at M. D. Anderson. The cancer has often spread to the lymph system or beyond at the time of diagnosis. That's why it's so important for every woman to know the signs.

Inflammatory breast cancer appears on the skin of the breast. There's seldom a palpable lump. It may initially look like a bug bite or a breast infection, such as mastitis. The women in our IBC Clinic tell a similar story of noticing a small, red patch that spreads in a matter of days or weeks; a swollen, hot breast with no fever; and skin that is puckered or dimpled. If you notice these signs, don't delay getting to your physician. Your doctor may prescribe a round of antibiotics. If there isn't marked improvement after one course, pursue a referral to an IBC specialist.

So what's the good news here? While breast cancer as a whole will affect one in eight women in their lifetime, IBC is relatively rare. It accounts for about 2% to 6% of breast cancers. Our patients now have clinical trials for IBC that combine standard chemotherapies and targeted therapies like lapatinib. New agents are being tested in pre-clinical settings in our laboratories with more clinical trials set to open soon.

In M. D. Anderson's Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, our motto is "Teach it. Treat it. Beat it." We have assembled a team of clinicians, researchers and advocates who are passionate about raising awareness of inflammatory breast cancer, identifying tools for earlier diagnosis and new treatments that will mean better outcomes for our patients. Help us spread the word.

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