Rare Cancer Can Often Mimic Breast Infection

Published by Contra Costa Times

Posted on Wed, Nov. 15, 2006

By Marianne Bunce, RN

A WOMAN COMES IN for an urgent care appointment. She appears nervous and slightly pale. "My right breast has been bothering me. I probably just have an infection or something, but my husband is really worried."

Upon examination, her right breast is significantly larger than the left, warm to the touch and appears red. The possible causes include infection or inflammatory breast cancer (IBC), which is a fast-growing type of breast cancer.

"Breast cancer" is among the most frightening phrases heard by women and their loved ones. It is the most common female cancer in the United States and the primary cause of death in women ages 45 to 55 years.

Many breast cancers can be felt during a breast examination by a woman or her doctor, or detected by a mammogram.

IBC is a relatively rare type of breast cancer, but it is often advanced when diagnosed due to its aggressive nature.

The woman typically will see her doctor because one breast is enlarged, firm, and possibly itchy. The skin often appears red, warm and thickened, similar to the finely dimpled surface of an orange. Her doctor may not detect a lump, and treat her for a breast infection with antibiotics.

Sometimes in IBC, antibiotic treatment may appear to help. But IBC should be suspected if the swelling and other breast changes don't resolve completely.

The diagnosis may be made by a needle aspiration, in which cancer cells are removed from the breast through a needle, or by a biopsy, in which a piece of the affected breast is surgically removed.

Additional tests to determine if the tumor had spread (metastasized) and the appropriate treatment may include: a mammogram; blood tests (especially to check for spread to the liver); tests to see if the tumor is responsive to female hormones; x-rays and/or CT scan of the chest, abdomen and pelvis; a bone scan; a PET scan; and an MRI of the brain.

Unfortunately, most IBC tumors have spread to the lymph nodes in the armpit or elsewhere by the time the diagnosis is made, so a combination of aggressive therapies is necessary.

First, chemotherapy can reduce the size of the tumor before surgery.

Then, if the tumor is small enough, it may be possible to cure the cancer by surgically removing just the tumor (lumpectomy), and not the whole breast (mastectomy).

Surgery may involve removing the whole breast, as well as local lymph nodes in the armpit. Then, localized radiation therapy to the affected breast may be needed.

And finally, once the woman has healed from surgery, additional chemotherapy may be needed to maximize the potential for cure.

Hormonal therapy may be helpful if the initial studies showed that tumor growth was stimulated by female hormones.

For more information, contact the local American Cancer Society office at 800-227-2345 or visit the ACS Web site at www.cancer.org.

Bunce is an oncology clinical nurse specialist at Contra Costa Regional Medical Center in Martinez.