• Thickness, heaviness or visible enlargement of one breast
• Discoloration, giving the breast a red, purple, pink or bruised appearance covering a large portion of the breast
• Unusual warmth of the affected breast
• Dimpling or ridges on the skin of the affected breast, similar to an orange peel
• Tenderness, pain or aching
• Enlarged lymph nodes under the arm, above the collarbone or below the collarbone
• Flattening or turning inward of the nipple
• Swollen or crusted skin on the nipple
• Change in color of the skin around the nipple (areola)
Women who have any of these symptoms for more than a week should see their doctor. However, just one symptom should not be a cause for panic. In fact, all of these symptoms are also symptoms of other breast problems that are not dangerous.
Inflammatory breast cancer presents several challenges for diagnosis. First, the symptoms overlap with infections like mastitis. Second, most IBC patients do not have a lump that shows up on a mammogram. Third, most primary care doctors rarely see a case of IBC, so they may not realize that a patient has it. The facts that patients may be much younger than typical breast cancer patients and that the presentation symptoms vary widely depending on which lymph vessels are blocked make IBC complicated to diagnose.
Because IBC symptoms typically look like any of several types of infections, most doctors will start treatment with an antibiotic. This is a sensible measure because infections are common and IBC is rare, and the response (or lack of one) to the antibiotic is useful information in making the diagnosis. If the condition goes away with medicine, then the problem isn’t cancer. The Inflammatory Breast Cancer Research foundation recommends that if the antibiotic doesn’t work within a week that a biopsy be performed.
Another part of diagnosis usually includes some imaging tests. Sometimes IBC is referred to as a cancer that can’t be found on a mammogram. However, some women with IBC do have an underlying mass that will show up on a mammogram. About 70% of women with IBC have changes in their mammograms in skin thickness or breast density as well as other abnormalities. So it is important for patients to ask for their new images to be compared to previous ones. Ultrasounds and breast MRI’s may also find changes that indicate the possibility of IBC.