Historically, inflammatory breast cancer was treated by surgery and was associated with a 100 percent mortality rate. However, significant progress has been made in recent years using a combination of treatments, including chemotherapy, surgery and radiation therapy. The combined-treatment approach has vastly improved the prognosis for a woman with inflammatory breast cancer. What was once universally fatal is now a disease that results in half of women diagnosed being alive in five years and one-third of women diagnosed surviving 10 or more years.ChemotherapySeveral rounds of systemic therapy — usually chemotherapy — are required initially in the treatment of inflammatory breast cancer. With inflammatory breast cancer, the skin is swollen and fluid-filled, which makes operating on it difficult. It also may not heal well after an operation. Chemotherapy kills the cancer cells and allows the skin to become more normal, giving it the best chance for healing. Systemic therapy — which could include chemotherapy or hormone therapy — before surgery (neoadjuvant therapy) works to shrink the size of the cancerous area to make the operation most effective. Further chemotherapy treatments are often given after the operation in an effort to kill any cancer cells that remain.
SurgeryAfter neoadjuvant therapy, an operation to remove the affected breast (mastectomy) is recommended for women with inflammatory breast cancer. Surgery alone — without neoadjuvant therapy — offers a much smaller chance of a cure. Breast-conserving surgery (lumpectomy) isn't recommended for women with inflammatory breast cancer. Many women experience involvement of their underarm (axillary) lymph nodes with inflammatory breast cancer. During surgery, your surgeon will examine your axillary lymph nodes for evidence of the disease.
Radiation therapyAfter surgery, a course of radiation therapy further reduces the chances of local recurrence of the cancer. Radiation therapy might also be considered as a primary treatment in cases in which the cancerous area can't be operated on.
However, even after treatment with chemotherapy, surgery and radiation, recurrence rates remain high for this type of breast cancer. Because of this, your doctor may recommend further treatment (adjuvant therapy) to prevent the cancer from returning. This might include more chemotherapy, if you responded well to it before surgery, or hormone therapy, such as tamoxifen (Nolvadex) or anastrozole (Arimidex), if your cancer tests positive for estrogen receptors. Your doctor may also consider adjuvant therapy with trastuzumab (Herceptin), if your cancer cells are sensitive to this medication. You may be offered the opportunity to participate in a clinical trial to test new treatments for inflammatory breast cancer.
Reconstruction after surgery is a possibility, although not for all women treated for inflammatory breast cancer. Your options may be limited if you've had extensive radiation therapy.
Inflammatory Breast Cancer Treatment
