Our 24/7 cancer helpline provides information and answers for people dealing with cancer. We can connect you with trained cancer information specialists who will answer questions about a cancer diagnosis and provide guidance and a compassionate ear.
Our highly trained specialists are available 24/7 via phone and on weekdays can assist through video calls and online chat. We connect patients, caregivers, and family members with essential services and resources at every step of their cancer journey. Ask us how you can get involved and support the fight against cancer. Some of the topics we can assist with include:
For medical questions, we encourage you to review our information with your doctor.
Inflammatory breast cancer (IBC) is an uncommon type of invasive breast cancer that typically makes the skin on the breast look red and feel warm. It also may give the breast skin a thick, pitted appearance that looks a lot like an orange peel. These changes are caused by cancer cells blocking lymph vessels in the skin.
Because inflammatory breast cancer has reached these lymph vessels and has caused changes in the skin, it is considered to be at least a stage III breast cancer when it is diagnosed. IBC that has spread to other parts of the body is considered stage IV. These cancers typically grow quickly and can be challenging to treat.
Regardless of the stage of the cancer, participation in a clinical trial of new treatments for IBC is also a good option because IBC is rare, has a poor prognosis (outcome), and these studies often allow access to drugs not available for standard treatment.
IBC that has not spread outside the breast or to nearby lymph nodes is stage III. Treatment usually starts with chemotherapy (chemo) to try to shrink the tumor. If the cancer is HER2-positive, targeted therapy is given along with the chemo. This is typically followed by surgery (mastectomy and lymph node dissection) to remove the cancer. Radiation therapy often follows surgery. Sometimes, more chemo may be given after surgery but before radiation. If the cancer is hormone receptor-positive , hormone therapy is given as well (usually after all chemo has been given). Combining these treatments has improved survival significantly over the years.
Using chemo before surgery is called neoadjuvant or preoperative treatment. Most women with IBC will receive two types of chemo drugs (although not always at the same time):
Other chemo drugs may be used as well.
If the cancer is HER2-positive (the cancer cells make too much of a protein called HER2), the targeted therapy drug trastuzumab (Herceptin) is usually given, sometimes along with another targeted drug, pertuzumab (Perjeta). These drugs can lead to heart problems when given with an anthracycline, so one option is to give the anthracycline first (without trastuzumab or pertuzumab), followed by treatment with a taxane and trastuzumab (with or without pertuzumab).
For women who have:
the targeted drug olaparib (Lynparza) might be given to lower the risk of the cancer recurring. It is typically given for one year. When given this way, olaparib can help some women live longer.
If the cancer improves with chemo, surgery is typically the next step. The standard operation is a modified radical mastectomy, where the entire breast and the lymph nodes under the arm are removed. Because IBC affects so much of the breast and skin, breast-conserving surgery (partial mastectomy or lumpectomy) and skin-sparing mastectomy are not options. It isn’t clear that sentinel lymph node biopsy (where only one or a few nodes are removed) is reliable in IBC, so it is also not an option.
If the cancer does not respond to chemo (and the breast is still very swollen and red), surgery cannot be done. Either other chemo drugs will be tried, or the breast may be treated with radiation. Then if the cancer responds (the breast shrinks and is no longer red), surgery may be an option.
If breast radiation isn’t given before surgery, it is given after surgery, even if no cancer is thought to remain. This is called adjuvant radiation. It lowers the chance that the cancer will come back. Radiation is usually given 5 days a week for 6 weeks, but in some cases a more intense treatment (twice a day) can be used instead. Depending on how much tumor was found in the breast after surgery, radiation might be delayed until further chemo and/or targeted therapy (such as trastuzumab) is given. If breast reconstruction is to be done, it is usually delayed until after the radiation therapy that most often follows surgery.
Treatment after surgery often includes additional (adjuvant) systemic treatment. This can include chemo, targeted therapy, hormone therapy (tamoxifen or an aromatase inhibitor) if the cancer cells have hormone receptors, the oral chemo drug capecitabine (Xeloda) if the cancer is triple-negative, the PARP inhibitor olaparib (Lynparza) if the woman has a BRCA mutation,and/or trastuzumab, pertuzumab or ado-trastuzumab emtansine if the cancer is HER2-positive.
Patients with metastatic (stage IV) IBC are treated with systemic therapy. This may include:
One or more of these treatments might be used. Many times, a targeted drug is given along with chemotherapy or with hormone therapy. Surgery and radiation may also be options in certain situations. See Treatment of Stage IV (Metastatic) Breast Cancer for more information.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Costa R, Santa-Maria CA, Rossi G, et al. Developmental therapeutics for inflammatory breast cancer: Biology and translational directions. Oncotarget. 2017;8(7):12417–12432.
Curigliano G. Inflammatory breast cancer and chest wall disease: The oncologist perspective. Eur J Surg Oncol. 2018 Aug;44(8):1142-1147.
Dawood S, Merajver SD, Viens P, et al. International expert panel on inflammatory breast cancer: Consensus statement for standardized diagnosis and treatment. Ann Oncol. 2011;22:515−523.
Henry NL, Shah PD, Haider I, Freer PE, Jagsi R, Sabel MS. Chapter 88: Cancer of the Breast. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.
Jagsi R, King TA, Lehman C, Morrow M, Harris JR, Burstein HJ. Chapter 79: Malignant Tumors of the Breast. In: DeVita VT, Lawrence TS, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.
Menta A, Fouad TM, Lucci A, Le-Petross H, Stauder MC, Woodward WA, Ueno NT, Lim B. Inflammatory Breast Cancer: What to Know About This Unique, Aggressive Breast Cancer. Surg Clin North Am. 2018 Aug;98(4):787-800.
National Cancer Institute. Inflammatory Breast Cancer. 2016. Accessed at https://www.cancer.gov/types/breast/ibc-fact-sheet on August 24, 2021.
National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Breast Cancer. Version 7.2021. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf on August 24, 2021.
Raghav K, French JT, Ueno NT, et al. Inflammatory Breast Cancer: A Distinct Clinicopathological Entity Transcending Histological Distinction. PLoS One. 2016;11(1):e0145534. Published 2016 Jan 11. doi:10.1371/journal.pone.0145534.
Taghian A and Merajver SD. Inflammatory breast cancer: Clinical features and treatment. In Vora SR, ed. UpToDate. Waltham, Mass.: UpToDate, 2021. https://www.uptodate.com. Last updated November 25, 2020. Accessed August 24, 2021.
Last Revised: April 12, 2022