will ibc rash go away?

Both women and men can develop IBC. Compared to other forms of breast cancer, IBC tends to strike younger women and is more common in Black women than White women. Men who are diagnosed with IBC are older on average than female patients. IBC is often mistaken for other conditions. It's important to talk with a healthcare provider if you are experiencing symptoms.

This article will discuss the symptoms, diagnosis, and treatment of inflammatory breast cancer.

IBC is a fast-growing cancer that can block lymph and blood vessels in the breast. As a result, signs and symptoms develop quickly, sometimes over weeks or months. IBC may not contain a solid tumor that you can feel, and symptoms can be similar to those of other conditions.

It is essential to watch for physical changes and describe them to your healthcare provider.

Common symptoms of IBC include:

Researchers aren't sure what causes IBC specifically, but some risk factors have been identified, including:

IBC can be challenging to identify, but there is a set of criteria to help healthcare providers reach a diagnosis, such as:

Your healthcare provider will perform a clinical breast exam, including a visual check of your breast. This involves looking for changes in skin color that may be caused by cancer cells blocking the lymph nodes and vessels in your breast skin. If your breast is swollen, it may be caused by fluid buildup, a condition called edema.

If your breast skin is ridged, pitted, bumpy, or resembles an orange peel, that will also be noted.Your healthcare provider will also check the lymph nodes in your armpits.

After taking a careful medical history and doing a physical exam, your healthcare provider will likely order imaging studies or perform a breast biopsy to understand your symptoms further. These studies help diagnose IBC and help rule out conditions, such as mastitis, that can cause similar symptoms.

These tests include:

If a mass is noted, a breast biopsy may be performed. If a mass is not present, a skin biopsy will be done on the abnormal area of the affected breast.

IBC does not always present with a lump like other cancers. Instead, it grows in sheets (sometimes called "nests") and can spread through the body primarily via the lymphatic system.

IBC is classified either as stage 3 or stage 4, depending on how far it has spread in the body. Stage 3 cancers have spread to at least one lymph node but not to other body regions. Stage 4 cancer is similar to stage 3B, but the cancer has spread to distant body areas.

Inflammatory breast cancer is aggressive. Therefore, it is usually treated with a combination of therapies (sometimes called a "multimodal approach") to reduce the risk of recurrence.

Neoadjuvant chemotherapy refers to chemotherapy that is administered prior to surgery. A combination of drugs is usually given in cycles for four to six months, depending on how quickly the cancer is growing. In some cases, patients may receive additional chemotherapy after surgery (called adjuvant chemotherapy).

The most common surgery is modified radical mastectomy (removing the entire breast), which is similar to a mastectomy for other types of breast cancer. With IBC, however, the lining of the chest muscles is also removed. Sometimes, one of the chest muscles (pectoral minor) may be removed. In addition, most lymph nodes are also excised.

If women desire reconstructive surgery (plastic surgery to restore the appearance of the breast), it is usually delayed until at least six months after completion of radiation therapy.

Radiation therapy is usually performed after a mastectomy to treat the chest wall and remaining lymph nodes.

Many inflammatory breast cancers are HER2 positive (a protein that makes cancer grow), so treatment with HER2-targeted therapies can be effective in controlling the tumor. These drugs are usually given along with the other treatments after a diagnosis of IBC. If the cancer is sensitive to estrogen, hormone therapy may also be an option.

There are a number of clinical trials in progress for inflammatory breast cancer that are evaluating the combination of the treatments above as well as newer treatments, such as immunotherapy (treatment that uses your body's immune system to help fight cancer).

IBC has a higher risk of recurrence than some other forms of breast cancer. However, if recurrence does occur, treatment is available and may include HER2-targeted therapies, chemotherapy, or hormonal therapy. In addition, other medicines may be available in clinical trials.

Recurrence is possible at any time, whether months after treatment or years down the road, including:

Healthcare providers cannot predict which tumors will result in a recurrence with certainty.

The highest risk of recurrence occurs in the first few years following treatment. A person's risk of recurrence is reduced after being cancer free for five years.  IBC tends to come back earlier because it's more aggressive, progressing more quickly than other types of breast cancer.

After IBC treatment, healthcare providers monitor patients periodically to check for recurrence. Physical exams are done at follow-up visits every three to six months after diagnosis for the first three years, then space out to one to two times yearly. These checkups include annual mammograms.

Because the potential for recurrence with IBC is high, healthcare providers recommend performing monthly breast self-exams and paying close attention to symptoms of recurrence.

Inflammatory breast cancer is aggressive and affects both men and women. Symptoms include skin changes such as redness, rash, or dimpling. Once a biopsy and imaging are complete, IBC can be staged. Treatment for this type of breast cancer can include chemotherapy, hormonal therapy, or targeted therapy. You may also need surgery and radiation to treat IBC. Many clinical trials are looking into better treatment options for IBC.

Although getting a cancer diagnosis is difficult and life altering, it's important to remember that each person and every cancer is different. While treatment for IBC can be challenging there are long-term survivors of this disease. In addition, newer treatments often have fewer side effects than traditional chemotherapy drugs.

But what does that rash actually look like? And how can you distinguish it from other, more benign conditions?

To learn more, we went to Wendy Woodward, M.D., Ph.D., a radiation oncologist and researcher who specializes in the treatment of inflammatory breast cancer.

What does an inflammatory breast cancer rash look like?

That’s kind of hard to say, because not everyone’s rash looks the same. And, it doesn’t always look like a rash. Sometimes, you can just see the breast skin pores very clearly because they look exaggerated due to swelling. Or, there’s redness or some other type of discoloration of one breast.

The rash associated with inflammatory breast cancer can also vary in appearance based on someone’s skin tone. It may look dark or even purple on some women, rather than red. But there’s not a defining skin change that’s the same for everybody. And, no matter how early a rash is diagnosed as inflammatory breast cancer, it is always considered at least stage III.

What characteristics distinguish an inflammatory breast cancer rash from other kinds?

Speed is one factor. Inflammatory breast cancer is quite aggressive, and it can develop very, very quickly. So, if you notice a marked change in the size of your breast or in its color or texture over a few weeks — or even a few days or hours — you should get it evaluated right away.

In addition, though some women describe the rash as starting out small — or even resembling a bug bite — it often involves most of the breast within a very short time frame. So, a spreading rash deserves prompt attention, too.

Are there any other conditions that can cause rashes on the breast?

Yes. Mastitis is the top one. It’s fairly common during breastfeeding, so many people tend to assume that inflammatory breast cancer is just an infection. It gets mistaken for mastitis and abscesses a lot because most health care providers have never seen inflammatory breast cancer before. They tend to err on the side of the rash being caused by something more benign.

The number of people diagnosed with inflammatory breast cancer each year is incredibly small. It’s a drop in the bucket, compared to other types of breast cancer. And most people who notice changes in their breasts will not ultimately have breast cancer.

By the time patients get to MD Anderson’s specialized Inflammatory Breast Cancer Clinic, though, they’ve often already gone through multiple rounds of antibiotics with no improvement.

Have there been any advances in the diagnosis of inflammatory breast cancer, based on rashes?

Yes. We’re working on two different projects right now.

One is an update of the MD Anderson cancer algorithm to help patients obtain a faster diagnosis. If the changes they’ve noticed are enough to point to inflammatory breast cancer, they’ll be able to use this algorithm to back up their request for additional imaging or a breast biopsy.

That way, if a doctor says, “OK, here are some more antibiotics,” patients can say, “Wait. Shouldn’t we try to rule this out first?” and show them the MD Anderson algorithm. A lot of doctors think of a breast biopsy as a really big step. But in this case, it’s not. It’s just the right thing to do.

We’re also in the very early stages of developing of an app that would let patients take a picture of their own breast, upload it and use artificial intelligence to compare it to photos of both healthy breasts and those from patients with confirmed inflammatory breast cancer diagnoses. The hope is to give patients a gauge to determine whether their rash is something to be concerned about and doctors a tool to make a diagnosis right away.

Is there anything else people should know about inflammatory breast cancer rashes?

There are a handful of other conditions can share symptoms with inflammatory breast cancer, including the following:

Mastitis is a condition characterized by inflammation and infection of the breast tissue. Mastitis most often occurs during breastfeeding, when milk ducts become blocked and milk buildup occurs.

Many symptoms of mastitis are similar to those of IBC and may include:

In most cases, mastitis causes symptoms that IBC doesn’t, such as headache, fever, or nipple discharge.

Hormonal changes, such as those that occur before menstruation or during pregnancy, are a common cause of breast pain, breast tenderness, and sudden changes in breast size.

Unlike IBC, these hormonal symptoms are generally mild and are accompanied by other symptoms, such as:

Hormonal changes do not tend to cause some of the other symptoms of IBC, like redness or inflammation.

Dermatitis is an umbrella term for a handful of inflammatory skin conditions that cause symptoms such as redness, itching, peeling, and more. Atopic dermatitis, contact dermatitis, dyshidrotic dermatitis, and seborrheic dermatitis are the most common types.

When dermatitis affects the skin of the breasts, symptoms can resemble IBC and may include:

Unlike IBC, breast dermatitis tends to affect only the skin of the breast, rather than the underlying breast tissue.

Breast injuries that cause trauma to the breast and surrounding areas can cause symptoms that mimic IBC, such as pain, tenderness, and bruising. Direct physical contact, repetitive movements, and surgery are the most common causes of breast injuries.

Inflammatory breast cancer can also cause the breast to feel heavy, tender or warm. A burning sensation, pain or itchiness may be present. Changes in skin typically cover at least one-third of the breast, although some rashes more closely resemble a small insect bite. An early inflammatory breast cancer rash may appear as a bruise that doesn’t go away or a subtle change in breast skin that progresses rapidly over the course of a few weeks.

In inflammatory breast cancer, “nests” of cancer cells invade and block the lymph vessels in breast skin. Lymph vessels collect and filter lymph, a clear fluid that contains white blood cells and flows throughout the body’s lymphatic system. This blockage of vessels can result in noticeable swelling, redness and inflammation of the affected breast—what we know as an inflammatory breast skin cancer rash.

In addition to a breast rash, other possible signs and symptoms of inflammatory breast cancer include:

Most inflammatory breast cancer symptoms develop relatively quickly over three to six weeks. If you notice any unusual changes in the size, appearance, or texture of your breasts, promptly speak with a general physician or obstetrician/gynecologist who can evaluate your symptoms and refer you to a cancer specialist, if necessary.

It’s important to remember that inflammatory breast cancer is not the only cause of breast inflammation and increased tenderness. Mastitis, a noncancerous breast infection, is much more common than inflammatory breast cancer and can lead to many of the same symptoms, including:

However, unlike inflammatory breast cancer, mastitis is also known to cause:

Mastitis can affect any woman, but most often occurs in breastfeeding mothers. Breast tissue may become inflamed or infected as a result of clogged milk ducts or dry, cracked skin on a nipple. Common treatment approaches for mastitis include taking antibiotics or pain relievers, staying hydrated and regularly emptying the breast of milk. Mastitis should resolve quickly with treatment—if your symptoms don’t improve after a week of taking antibiotics, it’s important to let your physician know.

Other noncancerous conditions that can lead to a breast rash include:

Inflammatory breast cancer is rare but can occur in women and men of any age. It’s one of the few breast cancers that’s known to affect people younger than 40, although the average age at diagnosis is 52. Additionally:

Mammograms aren’t a reliable way to screen for inflammatory breast cancer, as this malignancy rarely produces a distinct breast lump that can be detected through an imaging test. The diagnostic process typically begins with an evaluation of the breast rash and other possible symptoms, followed by a breast ultrasound or a skin punch biopsy to collect a small sample of tissue for testing under a microscope. A biopsy is the only definitive way to rule out or confirm a diagnosis of inflammatory breast cancer.

Moffitt Cancer Center’s Don & Erika Wallace Comprehensive Breast Program is home to multispecialty team that focuses exclusively on breast malignancies. As a high-volume cancer center, our experts have an unparalleled level of experience treating uncommon and complex diseases like inflammatory breast cancer. Moffitt also works diligently to discover breakthroughs in treatment through our trailblazing clinical trial program, which gives eligible patients access to promising new therapies before they’re made widely available.

There are a handful of other conditions can share symptoms with inflammatory breast cancer, including the following:

Mastitis is a condition characterized by inflammation and infection of the breast tissue. Mastitis most often occurs during breastfeeding, when milk ducts become blocked and milk buildup occurs.

Many symptoms of mastitis are similar to those of IBC and may include:

In most cases, mastitis causes symptoms that IBC doesn’t, such as headache, fever, or nipple discharge.

Hormonal changes, such as those that occur before menstruation or during pregnancy, are a common cause of breast pain, breast tenderness, and sudden changes in breast size.

Unlike IBC, these hormonal symptoms are generally mild and are accompanied by other symptoms, such as:

Hormonal changes do not tend to cause some of the other symptoms of IBC, like redness or inflammation.

Dermatitis is an umbrella term for a handful of inflammatory skin conditions that cause symptoms such as redness, itching, peeling, and more. Atopic dermatitis, contact dermatitis, dyshidrotic dermatitis, and seborrheic dermatitis are the most common types.

When dermatitis affects the skin of the breasts, symptoms can resemble IBC and may include:

Unlike IBC, breast dermatitis tends to affect only the skin of the breast, rather than the underlying breast tissue.

Breast injuries that cause trauma to the breast and surrounding areas can cause symptoms that mimic IBC, such as pain, tenderness, and bruising. Direct physical contact, repetitive movements, and surgery are the most common causes of breast injuries.

Like IBC, breast injuries can cause a handful of inflammatory symptoms, including:

While most symptoms of IBC do not go away, the skin redness can come and go. What does inflammatory breast cancer pain feel like? Tenderness, redness, warmth, swelling, and itching are symptoms you may feel with IBC.