Inflammatory Breast Cancer Diagnosis

In rare cases, inflammatory breast cancer (IBC) may be discovered on a mammogram before presenting any symptoms. However, in most instances, it doesn't present itself with a lump that can be discovered on a mammogram or upon a physical exam. That's why it's important to be aware of its symptoms. 

Symptoms of IBC

Symptoms of IBC include:

  • Redness and swelling of the breast (which may develop rapidly)
  • Change in the skin texture on the breast, ridging of the skin, or peeling of the skin on the breast
  • Warmth, or hot feeling on the breast
  • Changes in the breast shape
  • Breast or nipple pain
  • Discharge from the nipple
  • Nipple inversion
  • A lump
  • Thickening of the nipple skin

Staging for IBC

Because inflammatory breast cancer by definition is locally advanced, its staging begins at Stage IIIB.

Stage IIIB

The tumor meets clinical criteria for inflammatory carcinoma (diffuse redness and enlargement of the breast, skin ridging, peau d’orange [a change in the skin texture that appears similar to the skin of an orange):

  • It has not spread to the lymph nodes.
  • It has spread to one to three axillary lymph nodes and/or tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy.
  • It has spread to four to nine axillary lymph nodes, or it has enlarged the internal mammary lymph nodes.

Stage IIIC

The tumor is any size (or can't be found), hasn't spread to distant sites and one of the following applies:

  • Cancer has spread to 10 or more axillary lymph nodes.
  • Cancer has spread to the lymph nodes under the clavicle (collar bone).
  • Cancer has spread to the lymph nodes above the clavicle.
  • Cancer involves axillary lymph nodes and has enlarged the internal mammary lymph nodes.
  • Cancer has spread to four or more axillary lymph nodes, and tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy.

Stage IV

The cancer can be any size and may or may not have spread to nearby lymph nodes. It has spread to distant organs or to lymph nodes far from the breast. The most common sites of spread are the bone, liver, brain or lung.

IBC Second Opinion

If you were diagnosed at another health care center, and are coming to Penn Medicine’s Abramson Cancer Center for treatment, or for a second opinion, additional diagnostic tests may be necessary.

That’s because we use specific diagnostic imaging tools, tests, and procedures that are often more modern than what is available elsewhere. The results of these tools help us to develop your personalized treatment plan.

In advance of your second opinion, we may request:

  • Pathology slides
  • Copies of recent images (CT scans, for example)
  • Health records
  • A list of dates and facts about your past treatments, personal health history, or any other facts and dates relevant to your current diagnosis

Come to your appointment with a list of as many questions as possible. Sometimes, it can be difficult to think of or remember everything during a visit. A list of questions prepared in advance will ensure you get the information you are looking for.

If you forget a question, or have more questions after your appointment, you can communicate with us via www.myPennMedicine.org, our secure patient portal. The portal allows for fluid communications with your entire team of health care providers.

Finally, plan to have a friend, family member or support person come with you to your diagnostic appointment. He or she can help take down information, recall the conversation and be of general support throughout the process.

IBC Diagnostic Tools

Penn Medicine has a full suite of diagnostic tools to diagnose inflammatory breast cancer.