Inflammatory Breast Cancer

The symptoms I experienced appeared gradually over the course of several months in the following order: firmness akin to inflammation, red splotchiness in a different location, red orange-peel-like skin in a second location, raised red rash in a third location, and nipple inversion. I never experience heat, itchiness, or pain, although these are common symptoms. Also, I was lactating as my symptoms were developing, greatly confounding and delaying my diagnosis. If you have these symptoms and they are NOT relieved by a course of antibiotics, demand a biopsy. My inflammatory breast cancer was only discovered after I found a surgeon who was concerned enough to do a biopsy. The symptoms I experienced appeared gradually over the course of several months in the following order: firmness akin to inflammation, red splotchiness in a different location, red orange-peel-like skin in a second location, raised red rash in a third location, and nipple inversion. I never experience heat, itchiness, or pain, although these are common symptoms. Also, I was lactating as my symptoms were developing, greatly confounding and delaying my diagnosis. If you have these symptoms and they are NOT relieved by a course of antibiotics, demand a biopsy. My inflammatory breast cancer was only discovered after I found a surgeon who was concerned enough to do a biopsy.

The hardest part of IBC is diagnosing it. Once you have the diagnosis, it is probably less challenging to find the right person to treat it.


I live in a rural area and was not expecting to get adequate care here. However, I was referred to one of the five oncologists in town, and she is fantastic. She trained at MD Anderson in Houston, which I would argue is the premiere place for inflammatory breast cancer treatment. But I have since learned that as long as you are in the care of a knowledgeable oncologist, there is no reason to travel to a place like MD Anderson. I received the same treatments here that I would have received at MD Anderson.

In short, of primary importance is finding an intelligent and caring oncologist to supervise your care. You might not have to travel very far at all.

Secondly, find a surgical oncologist who you trust to remove all breast tissue. I understand that some surgeons and patients are more concerned with the cosmetic outcome of the mastectomy than with the mastectomy itself. But with inflammatory breast cancer, you do not have that luxury. Make sure you have a surgeon who understands the importance of a careful and thorough mastectomy.

Again, both of these points have less to do with location than with individuals. You can find crappy doctors at major cancer centers just as well as at rural cancer centers. Don't be afraid to try out a dozen different doctors in search of the right one for you. You just have to make an appointment and meet them! The hardest part of IBC is diagnosing it. Once you have the diagnosis, it is probably less challenging to find the right person to treat it.


I live in a rural area and was not expecting to get adequate care here. However, I was referred to one of the five oncologists in town, and she is fantastic. She trained at MD Anderson in Houston, which I would argue is the premiere place for inflammatory breast cancer treatment. But I have since learned that as long as you are in the care of a knowledgeable oncologist, there is no reason to travel to a place like MD Anderson. I received the same treatments here that I would have received at MD Anderson.

In short, of primary importance is finding an intelligent and caring oncologist to supervise your care. You might not have to travel very far at all.

Secondly, find a surgical oncologist who you trust to remove all breast tissue. I understand that some surgeons and patients are more concerned with the cosmetic outcome of the mastectomy than with the mastectomy itself. But with inflammatory breast cancer, you do not have that luxury. Make sure you have a surgeon who understands the importance of a careful and thorough mastectomy.

Again, both of these points have less to do with location than with individuals. You can find crappy doctors at major cancer centers just as well as at rural cancer centers. Don't be afraid to try out a dozen different doctors in search of the right one for you. You just have to make an appointment and meet them!

I had never heard of Inflammatory Breast Cancer before being diagnosed with it, but now know I had rather classic symptoms. At the beginning of July 2008 my breast became very itchy, with no sign of an insect bite. I had always had larger breasts and had done self-examination and even been proactive in having a mammagram at 42 years old (free screening starts in New Zealand at 45) but nothing about an itchy breast signalled breast cancer to me. It was relieved somewhat by topical ointments but remained itchy, sometimes aggravantingly so. I thought it was washing powder residue in my bra or some such thing irritating my skin.
About a week and a half later, on the first day of my period my breast started aching - as I was 45 and it was the first day of my period - I put it down to hormonal pain.
3 days later it was still aching. I put my bra on in the morning and my breast still looked normal to me. When I took it off that night - it was big, red and funny-looking. There was swelling and redness over approximately 75% of my right breast. I was a 'G' cup and it had swelled to an 'H' the skin was very puffy looking and the pores were sunken, giving it the classic 'orange peel' look. The aureole around my nipple was puckered and raised and had gone a paler colour and my nipple had inverted, and this had all just happened in the course of a day.
I managed to get to the Drs a day and a half later. My GP - primary care Dr - started me on antibiotics and saw me every couple of days to monitor response. When there had been no response after a week, even though he still thought it was an infection, he decided to send me to see a private breast clinic, that deals with all sorts of breast issues. (side-note New Zealand has a public health system but there are private specialists working in most fields as well)
He told me I needed to see them straight away and I managed to get an appointment that same week (less than 2 weeks after my breast 'blew up')
The very first visit the breast physician suspected IBC, although she didnt tell me. Ultrasounds, mammogram were done. Ultrasound showed a small collection of fluid in one part of my breast. Mammogram just showed my right breast was denser than my left and that the skin layers itself were 4mm thick . They did a final needle aspiration of the collection of fluid, and when that came out clear, then proceeded to take several samples of core needle biopsies. I was told to come back on Monday for the results. Naively, even though they had taken tissue, I didnt seriously think 'cancer' as nothing in my symptoms reflected anything I had ever heard about breast cancer.
On Monday, we were told the news, they warned us to be careful what we read on the internet and that I would have to start chemotherapy as soon as possible and that I would eventually have to have a mastectomy and lose my entire breast. They referred me to an oncologist and we had CT and bone scans done privately within a week to expedite the start of my treatment. The CT and Bone scan showed that I had no distant metastasis at that stage, but that the cacner was in my breast, axillary nodes and supraclavicular nodes (above the collar bone). I started Chemo 3 weeks after diagnosis in the public health system. I had never heard of Inflammatory Breast Cancer before being diagnosed with it, but now know I had rather classic symptoms. At the beginning of July 2008 my breast became very itchy, with no sign of an insect bite. I had always had larger breasts and had done self-examination and even been proactive in having a mammagram at 42 years old (free screening starts in New Zealand at 45) but nothing about an itchy breast signalled breast cancer to me. It was relieved somewhat by topical ointments but remained itchy, sometimes aggravantingly so. I thought it was washing powder residue in my bra or some such thing irritating my skin.
About a week and a half later, on the first day of my period my breast started aching - as I was 45 and it was the first day of my period - I put it down to hormonal pain.
3 days later it was still aching. I put my bra on in the morning and my breast still looked normal to me. When I took it off that night - it was big, red and funny-looking. There was swelling and redness over approximately 75% of my right breast. I was a 'G' cup and it had swelled to an 'H' the skin was very puffy looking and the pores were sunken, giving it the classic 'orange peel' look. The aureole around my nipple was puckered and raised and had gone a paler colour and my nipple had inverted, and this had all just happened in the course of a day.
I managed to get to the Drs a day and a half later. My GP - primary care Dr - started me on antibiotics and saw me every couple of days to monitor response. When there had been no response after a week, even though he still thought it was an infection, he decided to send me to see a private breast clinic, that deals with all sorts of breast issues. (side-note New Zealand has a public health system but there are private specialists working in most fields as well)
He told me I needed to see them straight away and I managed to get an appointment that same week (less than 2 weeks after my breast 'blew up')
The very first visit the breast physician suspected IBC, although she didnt tell me. Ultrasounds, mammogram were done. Ultrasound showed a small collection of fluid in one part of my breast. Mammogram just showed my right breast was denser than my left and that the skin layers itself were 4mm thick . They did a final needle aspiration of the collection of fluid, and when that came out clear, then proceeded to take several samples of core needle biopsies. I was told to come back on Monday for the results. Naively, even though they had taken tissue, I didnt seriously think 'cancer' as nothing in my symptoms reflected anything I had ever heard about breast cancer.
On Monday, we were told the news, they warned us to be careful what we read on the internet and that I would have to start chemotherapy as soon as possible and that I would eventually have to have a mastectomy and lose my entire breast. They referred me to an oncologist and we had CT and bone scans done privately within a week to expedite the start of my treatment. The CT and Bone scan showed that I had no distant metastasis at that stage, but that the cacner was in my breast, axillary nodes and supraclavicular nodes (above the collar bone). I started Chemo 3 weeks after diagnosis in the public health system.

If you have inflammatory breast cancer by definition it involves the skin. When I have patients with IBC who has completed treatment, I evaluate them clinically and I also take punch (skin) biopsies to make sure there is no further involvement of cancer in the dermis of the skin before I perform a mastectomy. I would generally take an ellipse of skin around the nipple areola complex including any areas that may have been involved by cancer that to reduce the risk of local recurrence. Hope this helps and good luck. If you have inflammatory breast cancer by definition it involves the skin. When I have patients with IBC who has completed treatment, I evaluate them clinically and I also take punch (skin) biopsies to make sure there is no further involvement of cancer in the dermis of the skin before I perform a mastectomy. I would generally take an ellipse of skin around the nipple areola complex including any areas that may have been involved by cancer that to reduce the risk of local recurrence. Hope this helps and good luck.

I was originally diagnosed with IBC in Aug 2008, with breast, axillary and supraclavicular node(above the collarbone) involvement making me a stage 3, my frist recurrence 5 months after initial treatment was in my internal mammary lymph node - a loco-regional recurrence still a stage 3. this year it has gone to my liver as Dr Ueno states above this is considered a distant metastasis there for stage 4. So I would be the exception to the in general rule as my first recurrence was still within stage 3 parameters Yes, in general. When inflammatory breast cancer comes back it usually comes to a location outside of the original area (distant metastasis). All metastasis is consider Stage IV. Whether inflammatory breast cancer metastatic disease behaves differently from non-inflammatory breast cancer behaves differently is controversial. But, there is an intensive research going on to understand the biology of IBC metastasis.

In general, surgery is not indicated for a recurrent inflammatory breast cancer. However, there is always an exception depending on the clinical situation. This case is something that we should not be commenting based on the information provided on the net. I recommend to see a multidisciplinary team with a experience in inflammatory breast cancer. In general, surgery is not indicated for a recurrent inflammatory breast cancer. However, there is always an exception depending on the clinical situation. This case is something that we should not be commenting based on the information provided on the net. I recommend to see a multidisciplinary team with a experience in inflammatory breast cancer.

If you have symptoms that are worrisome of IBC or Paget's disease of the breast it is important that you have a skin/punch biopsy to rule out this diagnosis.
I would urge any woman who is experiencing symptoms to get a second opinion such as seeing another pcp or even going to a dermatologist. If your insurance does not require referrals make an appointment to see a breast specialist/surgeon. Do NOT ignore any symptoms because every person has a different severity in their presentation of IBC or Paget's disease of the breast.
Hope that helps.
Heather
www.mybreastcanceranswers.com If you have symptoms that are worrisome of IBC or Paget's disease of the breast it is important that you have a skin/punch biopsy to rule out this diagnosis.
I would urge any woman who is experiencing symptoms to get a second opinion such as seeing another pcp or even going to a dermatologist. If your insurance does not require referrals make an appointment to see a breast specialist/surgeon. Do NOT ignore any symptoms because every person has a different severity in their presentation of IBC or Paget's disease of the breast.
Hope that helps.
Heather
www.mybreastcanceranswers.com

Great question! Inflammatory breast cancer is a clinical diagnosis, meaning it is diagnosed by visible signs. Right now there is no diagnostic test to determine if a patient has inflammatory breast cancer.

To be proactive it is important to pay attention to your body. As suggested by breast self-exam, look in a mirror at your breasts. Notice if there is a change in the size, shape, skin color or texture of the breasts. Compare one with the other. If you notice a change of any kind see your healthcare provider to rule out inflammatory breast cancer if the change doesn't resolve within two weeks on its own.

Inflammatory breast cancer usually develops suddenly and worsens fairly quickly.

Fortunately most breast changes are not cancer but it's important not to ignore things. Great question! Inflammatory breast cancer is a clinical diagnosis, meaning it is diagnosed by visible signs. Right now there is no diagnostic test to determine if a patient has inflammatory breast cancer.

To be proactive it is important to pay attention to your body. As suggested by breast self-exam, look in a mirror at your breasts. Notice if there is a change in the size, shape, skin color or texture of the breasts. Compare one with the other. If you notice a change of any kind see your healthcare provider to rule out inflammatory breast cancer if the change doesn't resolve within two weeks on its own.

Inflammatory breast cancer usually develops suddenly and worsens fairly quickly.

Fortunately most breast changes are not cancer but it's important not to ignore things.

Of course we would suggest the Inflammatory Breast Cancer Research Foundation, www.ibcresearch.org, which would include the website, Facebook page, and e-newsletter. Content is regularly updated and reviewed for accuracy and usefulness.

For current medical journal articles it is always best to go to PubMed and type in "inflammatory breast cancer" to locate the most recently published articles. Unfortunately those are often in subscription only journals so you may only be able to read the abstract but can contact the corresponding author for more information.

The National Cancer Institute has a good fact sheet:
http://www.cancer.gov/cancertopics/factsheet/Sites-Types/IBC

Many major medical centers have information about inflammatory breast cancer and those who see more cases may have some research data as well as clinical trials.

It's important to be cautious when exploring the internet for health related information. Not all websites have physician overview and may contain more personal opinion than unbiased medical information. Of course we would suggest the Inflammatory Breast Cancer Research Foundation, www.ibcresearch.org, which would include the website, Facebook page, and e-newsletter. Content is regularly updated and reviewed for accuracy and usefulness.

For current medical journal articles it is always best to go to PubMed and type in "inflammatory breast cancer" to locate the most recently published articles. Unfortunately those are often in subscription only journals so you may only be able to read the abstract but can contact the corresponding author for more information.

The National Cancer Institute has a good fact sheet:
http://www.cancer.gov/cancertopics/factsheet/Sites-Types/IBC

Many major medical centers have information about inflammatory breast cancer and those who see more cases may have some research data as well as clinical trials.

It's important to be cautious when exploring the internet for health related information. Not all websites have physician overview and may contain more personal opinion than unbiased medical information.

The most common symptoms of inflammatory breast cancer include but are not limited to:
-Rapid, unusual increase in breast size
-Redness, rash, blotchiness' of the breast skin
-What appears to be a 'bug bite' or 'bruise' that doesn't go away
-Persistent itching of breast and/or nipple
-Lump or thickening of breast tissue
-Stabbing pain, soreness, aching or heaviness similar to breast feeding
-Feverish breast (increased warmth)
-Swelling of lymph nodes under the arm or above the collar bone
-Dimpling or ridging of breast
-Flattening or retracting of nipple
-Nipple discharge or change in pigmented area around nipple
* The above symptoms may indicate a benign breast disorder. However any change to your breast(s) should be reported to your physician immediately, if it doesn't resolve within two weeks on its own.

Inflammatory breast cancer is more common in younger women and tends to have a higher incidence in African American women. Some other ethnic groups also show a slight increase in incidence. Statistics on inflammatory breast cancer are challenging because the disease is less common and often recorded as simply advanced breast cancer in the patient's medical record. The most common symptoms of inflammatory breast cancer include but are not limited to:
-Rapid, unusual increase in breast size
-Redness, rash, blotchiness' of the breast skin
-What appears to be a 'bug bite' or 'bruise' that doesn't go away
-Persistent itching of breast and/or nipple
-Lump or thickening of breast tissue
-Stabbing pain, soreness, aching or heaviness similar to breast feeding
-Feverish breast (increased warmth)
-Swelling of lymph nodes under the arm or above the collar bone
-Dimpling or ridging of breast
-Flattening or retracting of nipple
-Nipple discharge or change in pigmented area around nipple
* The above symptoms may indicate a benign breast disorder. However any change to your breast(s) should be reported to your physician immediately, if it doesn't resolve within two weeks on its own.

Inflammatory breast cancer is more common in younger women and tends to have a higher incidence in African American women. Some other ethnic groups also show a slight increase in incidence. Statistics on inflammatory breast cancer are challenging because the disease is less common and often recorded as simply advanced breast cancer in the patient's medical record.

Thanks to 'ibcsurvivor' who posted that photos are available at www.ibcresearch.org, our website! It is challenging to find good representative photos of inflammatory breast cancer (IBC). IBC can present in many different ways and medical textbook photos often show very advanced, rather extreme cases. Not everyone presents with a totally red, swollen breast as is often described.

The Inflammatory Breast Cancer Research Foundation has been in the process of updating the photo section of the website. There are more photos of primary disease and new ones of skin metastasis. Coming soon will be a patient's journey from diagnosis through treatment, in pictures.

The organization welcomes photos from patients who are willing to share and we're particularly interested in expanding the photo section to include a broader range of skin tones and ethnicities. Photos are posted anonymously to protect confidentiality. Hopefully this is a valuable resource for those who have worrisome symptoms and need guidance. ibcresearch.org has some photos

Unfortunately there isn't just one place you can go to see all clinical trials that are currently open. One source is clinicaltrials.gov which is a reliable source for clinical trials. CenterWatch is another and then individual hospitals/medical centers may have ongoing trials that aren't listed on these resources. When I checked clinicaltrials.gov and typed in "inflammatory breast cancer" I got 16 trials that are recruiting and include IBC patients. There were 3 trials with 'unknown' status, and 1 'not yet recruiting'. A few of these are registry trials and not treatment related.

It's always useful to consider a clinical trial when exploring treatment options but also very important to look carefully at the trial, who is sponsoring the trial, and how will participation in this trial impact future treatment.

Unfortunately many trials that include IBC patients don't separate out the data on the IBC patients so may not learn info specific to IBC. If we are to learn from clinical trial data the info on IBC patients must be studied on its own and kept separate from locally advanced or other patients. Unfortunately there isn't just one place you can go to see all clinical trials that are currently open. One source is clinicaltrials.gov which is a reliable source for clinical trials. CenterWatch is another and then individual hospitals/medical centers may have ongoing trials that aren't listed on these resources. When I checked clinicaltrials.gov and typed in "inflammatory breast cancer" I got 16 trials that are recruiting and include IBC patients. There were 3 trials with 'unknown' status, and 1 'not yet recruiting'. A few of these are registry trials and not treatment related.

It's always useful to consider a clinical trial when exploring treatment options but also very important to look carefully at the trial, who is sponsoring the trial, and how will participation in this trial impact future treatment.

Unfortunately many trials that include IBC patients don't separate out the data on the IBC patients so may not learn info specific to IBC. If we are to learn from clinical trial data the info on IBC patients must be studied on its own and kept separate from locally advanced or other patients.

Yes, I can except that I cannot give a specific. Angiogenesis is triggered by three main receptor VEGFR 1, VEGFR 2, and VEGFR 3. You can inhibit one of these receptor or two receptors, or three receptors. Further, some people approach inhibit the ligand (stimulant of receptor). Stopping the ligand is the approach of Bevacizumab (Avastin).

So the main question is wether the ligands or the receptors important in creating new blood vessels that can nurture the cancer more. The answer is that we do not have a clear cut answer. Therefore, the thought is why not inhibit all three receptors. Because we speculate that all three receptors promote inflammatory breast cancer to be aggressive, we feel that is worth testing a drug that inhibit all three receptors.
Yes, I can except that I cannot give a specific. Angiogenesis is triggered by three main receptor VEGFR 1, VEGFR 2, and VEGFR 3. You can inhibit one of these receptor or two receptors, or three receptors. Further, some people approach inhibit the ligand (stimulant of receptor). Stopping the ligand is the approach of Bevacizumab (Avastin).

So the main question is wether the ligands or the receptors important in creating new blood vessels that can nurture the cancer more. The answer is that we do not have a clear cut answer. Therefore, the thought is why not inhibit all three receptors. Because we speculate that all three receptors promote inflammatory breast cancer to be aggressive, we feel that is worth testing a drug that inhibit all three receptors.

Unfortunately, this is most likely consider as a stage IV. It is very important that you seek second opinion at Breast Center specializing in inflammatory breast cancer such as at MD Anderson Cancer Center and/or Phase I/II program that provide multiple clinical trial options. As long as feeling well, there are many choices to explore. Unfortunately, this is most likely consider as a stage IV. It is very important that you seek second opinion at Breast Center specializing in inflammatory breast cancer such as at MD Anderson Cancer Center and/or Phase I/II program that provide multiple clinical trial options. As long as feeling well, there are many choices to explore.

If you are looking for serious medical articles, you can go to a medical library and ask for the followng articles to be pulled. I hope that this will guide you.

The other is for you to learn how to use PubMed (http://www.ncbi.nlm.nih.gov)
And do a search by inflammatory breast cancer.

The other website for the latest update related to inflammatory breast cancer is
http://www.facebook.com/InflammatoryBreastCancer


Inflammatory breast cancer: the disease, the biology, the treatment.
Robertson FM, Bondy M, Yang W, Yamauchi H, Wiggins S, Kamrudin S, Krishnamurthy S, Le-Petross H, Bidaut L, Player AN, Barsky SH, Woodward WA, Buchholz T, Lucci A, Ueno NT, Cristofanilli M.
CA Cancer J Clin. 2010 Nov-Dec;60(6):351-75. Epub 2010 Oct 19. Review. Erratum in: CA Cancer J Clin. 2011 Mar-Apr;61(2):134. Ueno, Naoto [corrected to Ueno, Naoto T].
PMID: 20959401 [PubMed - indexed for MEDLINE] Free Article
Related citations

2.
International expert panel on inflammatory breast cancer: consensus statement for standardized diagnosis and treatment.
Dawood S, Merajver SD, Viens P, Vermeulen PB, Swain SM, Buchholz TA, Dirix LY, Levine PH, Lucci A, Krishnamurthy S, Robertson FM, Woodward WA, Yang WT, Ueno NT, Cristofanilli M.
Ann Oncol. 2011 Mar;22(3):515-23. Epub 2010 Jul 5.
PMID: 20603440 [PubMed - indexed for MEDLINE]
Related citations

3.
Molecular targets for treatment of inflammatory breast cancer.
Yamauchi H, Cristofanilli M, Nakamura S, Hortobagyi GN, Ueno NT.
Nat Rev Clin Oncol. 2009 Jul;6(7):387-94. Epub 2009 May 26. Review.
PMID: 19468291 [PubMed - indexed for MEDLINE]
Related citations

4.
The medical treatment of inflammatory breast cancer.
Dawood S, Ueno NT, Cristofanilli M.
Semin Oncol. 2008 Feb;35(1):64-71. Review. If you are looking for serious medical articles, you can go to a medical library and ask for the followng articles to be pulled. I hope that this will guide you.

The other is for you to learn how to use PubMed (http://www.ncbi.nlm.nih.gov)
And do a search by inflammatory breast cancer.

The other website for the latest update related to inflammatory breast cancer is
http://www.facebook.com/InflammatoryBreastCancer


Inflammatory breast cancer: the disease, the biology, the treatment.
Robertson FM, Bondy M, Yang W, Yamauchi H, Wiggins S, Kamrudin S, Krishnamurthy S, Le-Petross H, Bidaut L, Player AN, Barsky SH, Woodward WA, Buchholz T, Lucci A, Ueno NT, Cristofanilli M.
CA Cancer J Clin. 2010 Nov-Dec;60(6):351-75. Epub 2010 Oct 19. Review. Erratum in: CA Cancer J Clin. 2011 Mar-Apr;61(2):134. Ueno, Naoto [corrected to Ueno, Naoto T].
PMID: 20959401 [PubMed - indexed for MEDLINE] Free Article
Related citations

2.
International expert panel on inflammatory breast cancer: consensus statement for standardized diagnosis and treatment.
Dawood S, Merajver SD, Viens P, Vermeulen PB, Swain SM, Buchholz TA, Dirix LY, Levine PH, Lucci A, Krishnamurthy S, Robertson FM, Woodward WA, Yang WT, Ueno NT, Cristofanilli M.
Ann Oncol. 2011 Mar;22(3):515-23. Epub 2010 Jul 5.
PMID: 20603440 [PubMed - indexed for MEDLINE]
Related citations

3.
Molecular targets for treatment of inflammatory breast cancer.
Yamauchi H, Cristofanilli M, Nakamura S, Hortobagyi GN, Ueno NT.
Nat Rev Clin Oncol. 2009 Jul;6(7):387-94. Epub 2009 May 26. Review.
PMID: 19468291 [PubMed - indexed for MEDLINE]
Related citations

4.
The medical treatment of inflammatory breast cancer.
Dawood S, Ueno NT, Cristofanilli M.
Semin Oncol. 2008 Feb;35(1):64-71. Review.

I am guessing that you are asking how you develop a novel biomarkers or a new targeted therapy for breast cancer or inflammatory breast cancer.


There are several ways to approach this issues.

1. You collect large amoung of tissue and blood samples from breast cancer. Then you do a comprehensive analysis of genetic and protein changes (DNA, RNA, and protein). You link this data to a clinica data and find the one or them that can impact surveil or disease recurrence.

2. The other approach is discovery from basic research needs to be mined. And take their knowledge to apply by conducting a hypothesis oriented research. This means that you build up the puzzle one by one to prove the target is truly relevant in breast cancer.

Both approaches are important. Therefore, we do both and spend tremendous amount of time an money to come out with a strong scientific rationale before we can test this in human being. The problem we face is that there is not enough money and those who qualified to do this type of research.

Please asks me a more specific question. This may help me to answer this more accurately. I am guessing that you are asking how you develop a novel biomarkers or a new targeted therapy for breast cancer or inflammatory breast cancer.


There are several ways to approach this issues.

1. You collect large amoung of tissue and blood samples from breast cancer. Then you do a comprehensive analysis of genetic and protein changes (DNA, RNA, and protein). You link this data to a clinica data and find the one or them that can impact surveil or disease recurrence.

2. The other approach is discovery from basic research needs to be mined. And take their knowledge to apply by conducting a hypothesis oriented research. This means that you build up the puzzle one by one to prove the target is truly relevant in breast cancer.

Both approaches are important. Therefore, we do both and spend tremendous amount of time an money to come out with a strong scientific rationale before we can test this in human being. The problem we face is that there is not enough money and those who qualified to do this type of research.

Please asks me a more specific question. This may help me to answer this more accurately.

Unfortunately, there is no IBC specific chemotherapy for now. But in general, it is anthracycline (adriamycin, epirubicin) based or taxane (paclitaxel or docetaxel) based. For newly diagnosed IBC, both are used in sequence. Weekly paclitaxel followed by FAC (FEC) is our standard at MD Anderson Cancer Center IBC program. Unfortunately, there is no IBC specific chemotherapy for now. But in general, it is anthracycline (adriamycin, epirubicin) based or taxane (paclitaxel or docetaxel) based. For newly diagnosed IBC, both are used in sequence. Weekly paclitaxel followed by FAC (FEC) is our standard at MD Anderson Cancer Center IBC program.

Currently, there are no exception for the sequence of how the inflammatory breast cancer should be treated. The newly diagnosed inflammatory breast cancer without metastasis needs to receive systemic therapy (chemotherapy and/or targeted therapy), followed by surgery, and radiation. The surgery must be modified radical mastectomy. It is very important to see the IBC specialists.
Currently, there are no exception for the sequence of how the inflammatory breast cancer should be treated. The newly diagnosed inflammatory breast cancer without metastasis needs to receive systemic therapy (chemotherapy and/or targeted therapy), followed by surgery, and radiation. The surgery must be modified radical mastectomy. It is very important to see the IBC specialists.

Since inflammatory breast cancer grows in sheets or nests in the lymphatic layer of the skin, that puts it at a stage III B at diagnosis. If the cancerous cells (or tumor cell clusters) aren't in the lymphatic system to cause the visible skin changes, it isn't inflammatory breast cancer (IBC). IBC is diagnosed at stage III B, III C, or stage IV, depending on the extent of spread in the body.

The only true "early detection" for IBC is to be aware of breast changes. Look in the mirror regularly and look for differences. If you notice rapid increase in breast size, change in the color and/or texture of the breast skin, pain or itching of the breast, warmth or a heavy/full feeling in the breast, or other significant breast changes that don't resolve in 2 weeks it is time to see your healthcare professional. These symptoms can be the result of infection but if the symptoms aren't resolved with 7-10 days of antibiotic it's time to see a breast specialist to rule out IBC with a biopsy. Since inflammatory breast cancer grows in sheets or nests in the lymphatic layer of the skin, that puts it at a stage III B at diagnosis. If the cancerous cells (or tumor cell clusters) aren't in the lymphatic system to cause the visible skin changes, it isn't inflammatory breast cancer (IBC). IBC is diagnosed at stage III B, III C, or stage IV, depending on the extent of spread in the body.

The only true "early detection" for IBC is to be aware of breast changes. Look in the mirror regularly and look for differences. If you notice rapid increase in breast size, change in the color and/or texture of the breast skin, pain or itching of the breast, warmth or a heavy/full feeling in the breast, or other significant breast changes that don't resolve in 2 weeks it is time to see your healthcare professional. These symptoms can be the result of infection but if the symptoms aren't resolved with 7-10 days of antibiotic it's time to see a breast specialist to rule out IBC with a biopsy.

I was diagnosed with invasive ductal carcinoma-1 lymph node infected with micromets. I did incorporate integrative with my radiation treatment and did mostly naturopathic. I am doing quite well today and I personally felt that it helped my situation. Every one is different but I think just forgoing an integrative approach just because you may have an aggressive form of breast cancer may not always be the right approach to take. You do need to have a professional oversee everything you do from diet to supplementation that will also work with the other conventional doctors that you have. It is possible and for myself it worked out tremendously. It has been 2 years and I am doing so well that I was scheduled to have my check up with my radiation oncologist and my mammogram and I was told it wasn't necessary until next May since I am doing so well. I am not telling everyone that they should do this but you may want to check it out and research it-making sure you have a professional naturopathic oncologist or some other holistic professional willing to work with the regular oncologists. I just thought that I should add my thoughts since I did go through this protocol and for today I couldn't be doing better. I'm not familiar with any studies specific to inflammatory breast cancer (IBC) and complementary or alternative therapies. Given the aggressive nature of IBC I would not be uncomfortable suggesting that anyone abandon traditional chemotherapy options but I think it is appropriate to explore complementary therapies. Before embarking on any complementary or alternative treatments one should research reputable websites like: www.annieappleseedproject.org; www.cancer.gov/cam; mayoclinic.com/health/alternative-medicine, and the like.

Many patients report improvement in side effects and pain using complementary and/or alternative treatments and that's extremely helpful. Of course it is important that your treatment team know about any complementary or alternative treatments you are using, even vitamins or other supplements to avoid potential problems.