Inflammatory breast cancer, a rare type of cancer of the breast where the breast looks swollen and red, as if it is inflamed or infected, accounts for one to five per cent of all breast cancers. And it tends to occur in younger patients.

“This type of cancer spreads quickly to the lymphatics (vessels that drain fluid from tissues) blocking them off and causing the inflamed appearance. It progresses very quickly, it is very aggressive and often spreads within months if left untreated,” explains Joseph Debono, chairperson of the Department of Surgery at Mater Dei and a surgeon with an interest in breast and surgical oncology.

“Inflammatory breast cancer tends to occur in younger patients. They are frequently hormone receptor negative, which means that hormone therapies, such as Tamoxifen, are not effective and chemotherapy is often used in treating the tumour.”

Symptoms include swelling and redness that affect a third or more of the breast similar to an infection.

“The skin of the breast may also appear bruised as if after sustaining an injury and may also appear with pits and bumps like the skin of an orange,” points out Debono. “A lump is rarely felt”.

Other symptoms of inflammatory breast cancer include a rapid increase in breast size. Swollen lymph nodes may also be present under the arm.

So how is this cancer distinguishable from an infection?

“Failure of response to an initial course of antibiotics should trigger an alarm bell. Patients who present with any inflammatory changes of the breast affecting a third or more of the breast should undergo investigations. Mammography, however, might not be helpful and an ultrasound sometimes combined with a biopsy is usually needed.”

The chances of survival is half what is expected from normal breast cancer.

Treatment starts with chemotherapy to help shrink the tumour and minimise the chances of spread. This is followed by surgery.

“Mastectomy is usually the surgery of choice due to the advanced nature of the tumour,” says Debono. “This is then followed by radiotherapy to prevent local recurrence and further chemotherapy to reduce the chances of spread.”

Like other breast cancers, a healthy diet, exercise, weight control and avoiding smoking can prevent the onset of this type of cancer.

Debono stresses the importance of self-examination and reporting any changes in the breast “even if a mammogram has been done recently”.