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Inflammatory breast cancer rare, aggressive

By Judy Fortin
CNN

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ATLANTA, Georgia -- Sandra Mahncke thought she was coming down with the flu in late April, but instead of a quick recovery, she has spent the last five months in a race for her life.

She started feeling bad at work. "I had body aches and felt like I had a fever," says Sandra, "by the time I got home and changed my clothes I noticed that my left breast was very inflamed and bright red."

Those are classic symptoms of inflammatory breast cancer or IBC. According to the National Cancer Institute, IBC is "a rare but very aggressive type of breast cancer." It accounts for 1 to 5 percent of all breast cancer cases in the United States.(Watch Health Minute on inflammatory breast cancer -- 1:16 )

As with many other cases of IBC, Sandra's wasn't diagnosed right away. Her gynecologist thought she might have mastitis, a fairly common breast infection. When the redness and swelling didn't clear up after one course of antibiotics, the doctor ordered a mammogram. That's when Sandra first knew something was wrong. "Obviously, I was kind of shell-shocked and in disbelief," recalls Sandra. A breast surgeon broke the news that Sandra's biopsy tested positive for cancer. Sandra says, "It's very frightening and because it's an uncommon disease and we haven't heard a lot of stories from other people."

In spite of its name, Inflammatory breast cancer isn't caused by an inflammation or infection. Experts say IBC occurs when cancer cells block the lymph vessels in the skin of the breast. Surgical Oncologist Sheryl Gabram of the Winship Cancer Institute at Emory University in Atlanta, Georgia, says IBC "presents itself like an infection with redness and swelling, but unlike traditional breast cancer, there usually isn't a mass." There can also be ridging on the breast and an inverted nipple. A mammogram might reveal thickening skin. (Watch more on symptoms, treatment --6:31 )

Dr. Gabram says the best way to make the diagnosis is by looking at a woman's breast and obtaining a biopsy. While there are no specific risk factors, experts believe it is more common among African American women and those with a higher body mass index. Typically, IBC is diagnosed in younger women. Sandra is a 48-year-old mother of three teenage boys.

"Twenty years ago, women did not live beyond two years with this disease," says Dr. Gabram. Now, the National Cancer Institute puts the five-year survival rate between 25 and 50 percent. Part of the reason is early diagnosis, the other is aggressive treatment.

"Starting with chemotherapy first, to get control of the disease in the breast as well as throughout the body, followed by surgery and then radiation therapy can definitely decrease the local recurrence as well as increase survival," states Dr. Gabram.

Sandra is halfway through her chemotherapy sessions. She'll have a mastectomy in a couple of weeks. Her husband, Peter, is by her side as she's hooked up to an IV drip and administered chemo. Her doctors don't think the cancer has spread, but Dr. Gabram says IBC can be tricky and is more likely to metastasize than other cancers.

Despite her health crisis, Sandra believes she's lucky, and she's been told her prognosis is good. She advises other women not to wait and make an appointment with their doctor immediately if they notice any unusual changes in their breasts.

She says "it's a totally different world. You really have to shift gears and look at everything in a totally different way...it's definitely not easy. Having the support of doctors and nurses, friends and family makes a world of difference."

Judy Fortin is a correspondent with CNN's Medical Unit. Her Health Minute features appear Monday through Friday between 1 and 6 p.m. on CNN Headline News.

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