Q: Red, inflamed, hard, itchy, painful right breast; could this be Inflammatory Breast Cancer?
Three weeks ago I went to bed feeling completely healthy and normal. I had no noticeable symptoms in my breast. The following morning I woke up feeling very naseaus (without vomit), lightheaded, my ear was achy, and my right breast had changed overnight. It was a little pink just above the nipple and hard, it was also very tender and painful. I had to call in sick that day and remained in bed extremely weak and slept majority if the time. That evening my husband took me to the ER because my right breast was beginning to appear much larger than the left, redness was increasing and pain was only worse. The doctor ordered a spine tap, CT scan, and unltra sound, along with blood and urine samples. He advised me that he thought it was Cellulitis or Mestastis. This confused me because my children are 3yrs old and 6yrs old, I am 33yrs old, and my husband and I can no longer have children. They admitted me to the hospital and put me on different IV antibiotics. My body wasn't responding to them at all. In fact, my breast was only getting more inflamed (largest was 3x's larger than my left). My right breast was also feeling like a 2 ton brick, extremely painful, the skin was so tight that it looked shiny, and the lower half of my breast was looking like it had dimples. The pain seemed more severe on the upper half of the breast and towards my right armpit. I also was feeling shortness of breath, body aches, very weak, dizzy, no appetite, and sleepy. After 3 days of not responding to antibiotics and still in the hospital, we requested an infectious disease doctor. He took me off the existing antibiotics and started something new. He sent me home the following day with an IV line in my arm and had to return to his office for 7 days to receive the antibiotic through my IV. On the fourth day I noticed the swelling getting a little smaller and less painful, still red and dimples. On the fifth day I started to regain my strength and my breast began to 'blister' and peel. By the way, I did forget to mention that my right breast has been itchy from day 1 to today. After I finished the 7 days of the IV antibiotic, the doctor placed me on 2 oral antibiotics for 10 days. Today is day 13, my right breast is almost completely back to normal size, skin is still flaky and peeling, itchy, and pink, but dimples are almost completely gone and it finally feels almost exactly like the other one to touch (not hard and in squeezable) however, I do still feel slight tenderness and pain off and on and I remain tired, dizzy, and often feel weak. My mom, who is a nurse, is begging me to request a referral to the West Clinic and request a push biopsy to know for sure rather or not this is IBC. I need some advice. Should I beg them for the referral and biopsy or should I not mention it and wait and see how my breast does a few weeks after I have completed my oral antibiotics. Please help, thanks Jen
Hi Jen - Since IBC wouldn't typically respond to antibiotics, as yours did, this probably was, in fact, an infection of some kind; it's possible to get mastitis anytime, not just when you're nursing. Ditto cellulitis. Also, IBC wouldn't result in those more systemic symptoms – aches, fatigue, etc. However, if you want to rule out IBC entirely, your mom is right - a biopsy is the only way to do it.
We're not medically trained here, simply well-read breast cancer survivors; so we can't offer you medical advice, only a shoulder to lean on as you navigate through this. It's up to you to assess your level of worry; are you willing to wait and see if everything simply goes back to normal? If so, will you still be worried there might be IBC present somehow? Or would you believe this was an infection that's been treated and cured? It's a tough decision, I know, but you're the best person to make it; it's your body and mind, and you're the one ultimately responsible for your health, both physical and emotional. Best of luck as you move forward - I hope everything continues to heal uneventfully. PJH
Jen, PJ is correct that it would be extremely unusual for IBC to respond that well to antibiotics. Also an infection like mastitis or cellulitis often makes a person feel sick all over the way you did, but IBC usually does not. Clearly, your doctors took your problem very seriously what with the hospital admission and referral to the infectious disease expert. I would suggest you ask if IBC has been considered as a possible diagnosis and see what the doctor says about how your situation has been similar to and different from IBC. If the symptoms go away completely by the time you finish the full round of medicine, I think you can feel reasonably confident that you do not have IBC. While non-lactational mastitis is rare, so is IBC. My own primary care doctor told me once that she had seen one case of each in her 15 years of practice. If the symptoms linger, then I would urge you to see a breast surgeon to rule out IBC.
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