Rare breast cancer largely unknown, but a killer

Special to the Green Valley News

Rarely mentioned, unknown to most women and sometimes misdiagnosed by physicians because it accounts for only two to three percent of all breast cancers, Inflammatory Breast Cancer is now more openly publicized to urge women to seek medical help if they have any of the unusual signs — signs that often go ignored until the cancer is advanced.

According to the National Cancer Institute, IBC “is a rare but aggressive type of cancer in which the cancer cells block the lymph vessels in the skin of the breast.”

It’s called inflammatory because the breast is often swollen, red and appears inflamed. A red spot may appear that is often misdiagnosed as a bug bite.

“If you have (what looks like) a bug bite spot, get it checked out... Inflammatory Breast Cancer is a sub-type of breast cancer,” said Dr. Leona Downey, a breast cancer oncologist at the Arizona Cancer Center in Tucson. “It’s not new.”

One patient’s story

Maria Zambrano, 63, of Nogales, Arizona, was misdiagnosed for four months in 2007, and was on antibiotics for a presumed breast infection. She was fortunate to have her son and niece research and realize the symptoms were more than an infection.

Since there is often no distinct lump, Zambrano’s mammogram and ultrasound showed nothing alarming, but when diagnosed, a large mass was discovered under her right arm.

The aggressive cancer is often misdiagnosed, so when it is identified, it is often at Stage IIIB (locally advanced) or Stage IV (spread to other organs).

Downey said because of the aggressive nature of IBC, Zambrano’s cancer treatment started with chemotherapy, then a mastectomy followed by radiation.

“With the chemotherapy being done first we were able to see the mass get smaller; we saw a difference in one month,” Downey said.

“Following surgery and the course of treatments all the cancer was gone. Maria had a ‘pathologic complete response’; only about 30 percent of patients achieve that. She now has a 96 percent survival rate,” she said. IBC patients who only have surgery don’t usually survive five years, she added.

Though the cancer cells did invade the lymph nodes under Zambrano’s arm, the cancer did not spread. With chemotherapy, surgery and radiation in fall 2007, Zambrano now is doing well.

Her niece Maria Saavedra said her aunt is only on a twice-a-year infusion of bone-strengthening medication. She is undergoing lymphodema therapy for her swollen right arm, but she can function well.

“It was emotional seeing my family go through this with me,” Zambrano said. “There were some challenges with the treatment but nothing I couldn’t cope with.”

Arizona Cancer Center community outreach and education coordinator Ilya Sloan said sharing helps other women identify. Zambrano shared her story so others may avoid misdiagnosis that delays prompt treatment.

“Act on the change immediately,” Zambrano said. “Have lots of faith and trust in your doctors. Having an open relationship with Dr. Downey was very helpful, and my family never treated me like I was sick.”

Ellen Sussman is a freelance writer in Green Valley. Contact her at ellen2414@cox.net.

Facts to know

IBC tends to be diagnosed in women in their 40s and 50s, compared to non-IBC breast cancers.

Symptoms often include redness, swelling and warmth in the breast, often without a distinct lump. The skin may also have ridges or appear pitted, like the skin of an orange. The cells are growing through channels in the skin that make the breast appear as it does.

If in doubt, get a second or third opinion from a breast cancer oncologist.