UC HEALTH LINE: Rare But Aggressive Form of Breast Cancer Undetectable By Mammogram

CINCINNATI—Most women believe that having their annual mammograms and clinical breast exams is enough to catch cancer if it develops.

But University of Cincinnati (UC) breast cancer experts counsel that paying attention to even minor changes in breast appearance could save your life if you get a rare form of the disease known as “inflammatory” breast cancer. Unlike most other forms of breast cancer, they say, this disease is undetectable on a mammogram and doesn’t start as a lump.

“Inflammatory breast cancer starts as a tissue thickening or redness, versus a lump that can be felt,” explains Jennifer Manders, MD, assistant professor and breast surgeon at the UC, “so it often goes undetected until the disease has spread to the lymph nodes and possibly to other areas of the body.”

There are two primary types of breast cancer: noninvasive, which is localized to one place, and invasive, which can spread to other parts of the body. Inflammatory breast cancer is a very aggressive form of invasive cancer caused by a build-up of breast cancer cells that block the lymphatic vessels.

The body’s lymphatic system produces and stores cells to fight off infection and disease. Breast lymphatics, tiny channels similar to blood vessels, transport fluid from the breast tissue to the lymph node glands in the underarm, which in turn help to fight infection and disease. Inflammatory breast cancer cells enter directly into the lymphatic channels within the skin of the breast, allowing the disease to spread more quickly to other parts of the body.

Although scientists estimate that the disease represents only 1 to 5 percent of all breast cancers, it is one of the most difficult types to treat because it is often diagnosed in an advanced stage.

“There is a lack of awareness about this disease,” says Manders, “so women often dismiss the warning signs of inflammatory breast cancer because it’s not obvious that something is wrong.”

Those warning signs include painless skin discoloration or redness (similar to a bug bite), rapid increase in breast size, an inverted nipple, and enlarged lymph nodes in the underarms or neck. 

“Every woman should be familiar with the way her breasts look and feel normally,” adds Zeina Nahleh, MD, a medical oncologist and assistant professor at UC. “That way, she can quickly identify suspicious changes and have them examined immediately by a physician.”

Treatment for inflammatory breast cancer typically involves chemotherapy first, to halt the spread of cancer, followed by surgery to remove the lymph nodes and breast tissue and chest radiation to kill any remaining cancer cells.

“What’s important is that women recognize the warning signs before the disease becomes untreatable,” adds Nahleh.

For information on breast cancer clinical trials, call the UC Cancer Center research office at (513) 584-2951.