Inflammatory Breast Cancer

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Inflammatory breast cancer is a rare, aggressive form of breast cancer characterized by breast swelling, redness, and bruised or pitted skin. If symptoms occur, it’s important to seek care immediately from an inflammatory breast cancer specialist because the disease can spread quickly and the signs can be mistaken for a breast infection called mastitis. Duke’s team of inflammatory breast cancer specialists has the experience and tools to diagnose your cancer early and treat it effectively. Receiving your care at a major medical center like Duke will improve your chance of having a positive outcome.

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Understanding Inflammatory Breast Cancer

Inflammatory breast cancer is one of the most aggressive types of breast cancer. It is curable when diagnosed early and treated quickly. Watch this video to learn more.

Inflammatory Breast Cancer Symptoms
Unlike other forms of breast cancer that form a lump in the breast, inflammatory breast cancer is characterized by physical symptoms that develop rapidly. They are caused by cancer cells that block the flow of lymph fluid through the breast tissue. Signs of inflammatory breast cancer include:

Visible enlargement of one breast
Breast discoloration: the breast may turn red, purple, or pink, indicating bruising or inflammation is present
Visible breast skin changes including thicker breast skin, skin that looks pitted like an orange peel, and possible dimples or ridges in the skin
Tenderness, pain, and/or aching

Mastitis or Inflammatory Breast Cancer
Because these symptoms resemble mastitis, inflammatory breast cancer can be misdiagnosed. Mastitis is treated with antibiotics. If the symptoms don’t go away or worsen after antibiotic treatment, it’s important that you see an inflammatory breast cancer specialist immediately.

Hormone Receptor Status
Certain proteins that fuel cancer growth may be present when inflammatory breast cancer occurs. The hormone receptor status of your breast cancer determines the best approach to treatment. Aggressive hormone-positive, HER2, and triple-negative breast cancers are more likely to occur in Inflammatory breast cancer. Your doctor will perform several tests to determine if your cancer is:

Estrogen receptor positive (ER+)
Progesterone receptor positive (PR+)
HER2 positive (HER2 is a specific protein)
Hormone receptor-positive (estrogen and progesterone are present)
Triple-negative (estrogen, progesterone, and HER2 are not present)

Metastatic Inflammatory Breast Cancer
If cancer has spread to other parts of the body, it is called metastatic breast cancer. Inflammatory breast cancer can spread quickly. Seek care from a specialist if inflammatory breast cancer symptoms last longer than one week.

Recurrent Inflammatory Breast Cancer
Inflammatory breast cancer can return at any time. Scheduling regular follow-up appointments for exams and imaging with an inflammatory breast cancer specialist can ensure recurring breast cancer is caught early and treated immediately.

Diagnosing Inflammatory Breast Cancer

Your oncologist will perform a physical exam, request tests, and perform a skin punch biopsy of the breast tissue to identify subtypes, determine the stage of your cancer (how much cancer is present), and whether the cancer has spread. A diagnosis takes into consideration your symptoms, risk factors such as age (it is more common in younger women), health status, ethnicity (it is more common in Black women), previous cancer diagnoses, and test results.

Physical Exam

Your doctor will examine your breast and surrounding lymph nodes.

Blood Tests

Lab work may be ordered to look for tumor proteins when metastatic breast cancer is present.

Skin Punch Breast Biopsy

A skin punch biopsy removes breast skin and tissue for examination under a microscope to confirm the diagnosis.

Digital Mammography, Ultrasound and MRI

Mammography, ultrasound, and/or MRI may be used to determine if the cancer is in the lymph nodes.

PET Scan

Duke is one of the few places in the region to use a new imaging agent for PET scans to detect estrogen receptor-positive (ER+) breast cancer. PET-CT or CT and a bone scan can also determine if cancer has spread to other parts of the body. This is particularly important in people with metastatic or recurrent breast cancer.

Duke Cancer Center

The Duke Cancer Center Breast Clinic is staffed by specialists who provide consultations for people suspected of or diagnosed with breast cancer. People with known or suspected cancer can be seen by one of our cancer specialists within 72 hours.

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Inflammatory Breast Cancer Treatments

Inflammatory breast cancer benefits from many types of treatment performed either alone or in combination. It’s important to seek care from a major medical center like Duke, where a team of medical, surgical, and radiation oncologists combines their expertise to create a personalized treatment approach for your cancer. One or more of the following treatments may be part of your plan.

Chemotherapy

Chemotherapy is given systemically, usually through a port, to destroy as many cancer cells as possible before surgery. Chemotherapy that is given before surgery is called neoadjuvant chemotherapy.

Mastectomy

Surgical removal of the entire breast may be recommended following chemotherapy.

Axillary Lymph Node Dissection

Your surgical oncologist will remove several lymph nodes from under your arm.

External Beam Radiation Therapy

Radiation therapy uses high-energy beams to target and destroy cancer cells. Adjuvant radiation therapy may be given after surgery to destroy the remaining cancer cells. Neoadjuvant radiation therapy may be given before surgery if the cancer did not respond to chemotherapy. Your team will help decide which approach is right for you.

Targeted Therapy

Treatment that targets specific cancer genes, such as that used with cancers that test positive for the HER2 protein, may be prescribed. Your doctor will let you know if you are eligible to participate in clinical trials testing new types of targeted therapies.

Hormone Therapy

Hormone therapy, also called endocrine therapy, may be part of your treatment for breast cancer that tests positive for estrogen or progesterone receptors. Unlike hormone replacement therapy (HRT), hormone therapy blocks the hormones that cause cancer to grow.

Immunotherapy

This type of therapy is given intravenously to boost the body’s immune system and help it identify and destroy cancer cells and prevent them from recurring. It is used to treat advanced inflammatory breast cancer in people who are not candidates for surgery. You may be eligible to participate in clinical trials that are evaluating whether combinations of these therapies with other medications may extend survival or boost the drugs’ ability to attack cancer.

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Why Choose Duke

We Are an NCI-Designated Comprehensive Cancer Center
At National Cancer Institute-Designated Comprehensive Cancer Centers like Duke Health, you’ll work with breast cancer specialists whose level of expertise can only be found at a few cancer centers across the country. Our breast cancer specialists have years of experience treating inflammatory breast cancer.

Our Team Approach to Your Cancer Care
Your team includes medical, surgical, and radiation oncologists with specific expertise in inflammatory breast cancer. as well as physician assistants and nurse practitioners, specially trained oncology nurses, social workers, pharmacists, genetic counselors, nutritionists, and others. They help you every step of the way.

Patient Navigators Coordinate Your Care
Our patient navigators become your one-stop shop for scheduling appointments, coordinating your visits, communicating your test results, and planning your surgery. It’s their job to make your treatment journey easier by guiding you through it step by step. They are more than willing to answer all your questions along the way.

Metastatic and Molecular Tumor Boards Review Patients' Care
Duke breast medical oncologists hold weekly meetings called “tumor boards” for our patients with metastatic breast cancer. They discuss and review our patients’ care, identify optimal treatments, and screen for clinical trials. The molecular tumor board also meets weekly to review specific genetic abnormalities within all tumor types and evaluate optimal targeted therapies.

We Provide Second Opinions and Work with Your Local Doctor
If your home is not close to one of our cancer centers, we can provide a second opinion to review your cancer diagnosis and treatment options and partner with your local doctors to advocate for your care.

Our Support Services Follow You Through Your Journey
You’ll have access to the full range of services to help minimize the side effects of treatment and support you and your loved ones through your cancer journey. Our financial coordinators help you navigate ways to pay for your care.

Once Your Cancer Treatment Ends
We continue to monitor your health through our survivorship clinic. Our survivorship providers work together with your oncology team and primary physician to optimize your health and monitor for any long-term effects that might result from your treatment. We help you maintain a personalized plan that includes ongoing screenings to ensure you live your best possible life as a cancer survivor.

Leading Inflammatory Breast Cancer Research
Your medical team is actively involved in inflammatory breast cancer research. We partner with the Duke consortium to discover new ways to understand, prevent, and treat inflammatory breast cancer. Duke is also part of the Susan G. Komen Inflammatory Breast Cancer Foundation, which is working to improve the survival of inflammatory breast cancer patients.

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

This page was medically reviewed on 07/13/2022 by

Jeremy Force, DO | Medical Oncologist