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Diagnostic criteria — IBC is designated as T4d in the American Joint Committee on Cancer (AJCC) Tumor
Because inflammatory breast cancer forms in layers, your doctor may not feel a distinct lump during a breast exam and a mammogram may not

detect one either.  In most cases, inflammatory breast cancer is diagnosed after you or your doctor can see or feel breast changes such

as redness, swelling, warmth, or an orange-peel look to the skin.  Inflammatory Breast Cancer is a clinical Diagnosis (meaning visual) not a pathology diagnosis.​

Diagnosing Inflammatory Breast Cancer can be difficult since the cancer is not seen on mammograms, and mammograms are often painful and difficult for patients with a tender and swollen breast.  A skin punch or needle core biopsy, dedicated breast MRI, and/or PET (Positron Emission Tomography) scan may assist in determining the cause of symptoms.  

Family physicians are usually the entry point to the health care system and are well positioned to assess inflammation of the breast and recognize the warning signs of an underlying inflammatory breast cancer.  They are also important members of the team that provides support for breast cancer patients during treatment, follow-up, and end-of-life care.

​There is NO lump that can be felt during a physical examination or seen in a screening mammogram, this makes diagnosis harder than with other breast cancers.  The symptoms of inflammatory breast cancer may be mistaken for those of mastitis, which is an infection of the breast, or another form of locally advanced breast cancer.  Most IBC patients are young women.  It often strikes very young to young women before the recommended age 40.

Inflammatory Breast Cancer (IBC) is a relatively rare subtype of breast cancer, patients diagnosed with IBC faces many barriers throughout their diagnosis and treatment; anyone who has been through the experience will tell you the same thing.  Because there is such limited education and knowledge about IBC, patients can suffer for weeks before they are accurately diagnosed – and unfortunately because IBC spreads so rapidly, they just don’t have any time to spare.  According to the Inflammatory Breast Cancer International Consortium.  Like other types of breast cancer, inflammatory breast cancer can occur in men.

If you've been diagnosed with inflammatory breast cancer, it's completely understandable if you're feeling overwhelmed.  Keep in mind, though, that there are a variety of treatment options available for inflammatory breast cancer.

Tests For Diagnosis

Mammography has made it possible to detect many breast cancers before they produce and signs or symptoms.  HOWEVER,  Inflammatory breast cancer produces symptoms, so in the case of this cancer.  Due to the rapid spread of IBC, this breast cancer is sometimes found between the routine mammogram exams.  ​​

To diagnose inflammatory breast cancer, your doctor will perform a biopsy.  Biopsy is a surgical procedure that removes some of the suspicious breast tissue for examination under a microscope.

Because inflammatory breast cancer usually does not begin as a distinct lump, but instead as changes to the skin, a skin punch biopsy is often used to make the diagnosis.  If your doctor can see a distinct lesion, he or she may perform an ultrasound-guided core needle biopsy.  Ultrasound is an imaging method that places a sound-emitting device on the breast to obtain images of the tissues inside.  Guided by the ultrasound, the doctor inserts a hollow needle into the breast to remove several cylinder-shaped samples of tissue from the area of suspicion.

If the biopsy shows that inflammatory breast cancer is present, your doctor will order additional tests to figure out how much of the breast tissue and lymph nodes are involved, and whether or not the other breast is affected.   Breast MRI, or magnetic resonance imaging, is considered the most reliable test for gathering more information about inflammatory breast cancer

Once IBC is diagnosed, additional tests are used to determine whether the cancer has spread outside the breast to other organs, such as the lungs, bones, or liver.  This is called staging.  Tests that may be used  include:  Chest X-ray - CT scan (computerized tomography) of the chest, abdomen, and pelvis.  Bone scan to look for  spread (metastasis) to the bones and liver function tests.  You may want to ask your doctor whether this test would be useful in your treatment planning.  

Multiple-gated acquisition (MUGA) scan some, cancer treatments, such as certain chemotherapy drugs, can cause changes in heart function. Multiple-gated acquisition (MUGA) scans are used to evaluate and monitor changes in the function of the heart throughout a patient’s treatment.  MUGA scans help determine if the heart is pumping blood properly and, ultimately, if needed to modify a patient’s treatment regime. 

Another test is the positron emission tomography (PET) is a nuclear imaging technique that creates detailed, computerized pictures of organs and tissues inside the body.  A PET scan can be used to detect cancerous tissues and cells in the body that may not always be found through computed tomography (CT) or magnetic resonance imaging (MRI).

Definitive Diagnosis

To help prevent delays in diagnosis and in choosing the best course of treatment, an international panel of experts published guidelines on how doctors can diagnose and stage inflammatory breast cancer correctly. Their recommendations are summarized below.

Minimum criteria for a diagnosis of inflammatory breast cancer include the following:

  • The above-mentioned symptoms have been present for less than 6 months.
  • The redness covers at least a third of the breast.
  • Initial biopsy samples from the affected breast show invasive carcinoma​                                                                                                                              

Even if imaging tests show suspicious for breast cancer, definitive diagnosis requires a tissue sample, or biopsy.  A biopsy may be taken of a small area of the breast ( an incisional biopsy), or the entire abnormal area may be removed at the time of biopsy (excisional biopsy).  Biopsy allows the pathologist (a physician with special training in the diagnosis of diseases based on tissue samples) to determine if breast cancer is present, and if so, what type of breast cancer.  Biopsy also provides a tissue sample for further tests that are done to determine the best type of treatment.  The diagnosis of inflammatory breast cancer can be challenging.​​