Inflammatory Breast Cancer

Treatment

Patients with inflammatory breast cancer receive a combination of cancer-fighting drugs (chemotherapy) as well as surgery and radiation. A patient's treatment is based upon many factors, including the stage of the tumor and the patient's age and overall health.

Surgery

Mayo Clinic offers the latest surgical techniques and procedures to treat inflammatory breast cancer. Physicians at Mayo Clinic perform 750 surgeries for breast cancer per year. Research has demonstrated that patients who have breast cancer treatment at high-volume centers have better outcomes. Mayo Clinic's state-of-the-art equipment, facilities and research also play a role in successful diagnosis and treatment of inflammatory breast cancer.

Patients diagnosed with breast cancer often can be scheduled for surgery the next day, if desired. Surgeons provide patients with individualized information to help them decide which treatment is best.

Frozen sections. Mayo Clinic has a unique frozen section pathology lab, which allows for rapid and accurate microscopic analysis of tissue while a patient is still in the operating room. This capability allows doctors to know whether they have removed all of the cancer within minutes of removing the tissue. Without frozen section analysis, determining whether all cancer has been removed may take days and require multiple surgeries. Mayo Clinic physicians routinely use frozen-section evaluation of tissue during breast cancer surgery to avoid additional surgeries.

Evaluation of lymph nodes. Breast cancer usually spreads first to the axillary lymph nodes under the arm. Therefore, when an invasive cancer is found in the breast, the surgeon will recommend removing some underarm lymph nodes to determine if the cancer has spread. Surgeons at Mayo Clinic use three procedures to evaluate the lymph nodes, including sentinel lymph node biopsy, fine-needle aspiration and axillary lymph node dissection. Fine-needle aspiration may be performed prior to surgery if lymph nodes appear abnormal by ultrasound exam. Axillary lymph node dissection is performed when doctors know that cancer has spread to the lymph nodes. The majority of patients with breast cancer are unlikely to have cancer in the lymph nodes, and for this group sentinel lymph node biopsy is the recommended procedure.

Breast Reconstruction after Cancer Surgery

Breast reconstruction after cancer surgery is feasible in some cases. Surgical options offered at Mayo Clinic include reconstruction with implants and reconstruction using the patient's own tissue (autologous reconstruction) including TRAM surgery, DIEP surgery, SIEA surgery, and reconstruction of the nipple and areola.

Chemotherapy

A Mayo physician may recommend chemotherapy (drugs) before and/or after surgery to kill cancer cells that may have spread outside the breast. These drugs may be administered intravenously, in pill form or both.

Most patients receive chemotherapy after they heal from the operation and prior to radiation. The physician chooses the chemotherapy drugs and sequence of treatment based on the patient's situation. In some cases, chemotherapy may be given before surgery (but after a biopsy) to try to shrink the tumor, allowing for a simpler and possibly more effective operation.

Mayo Clinic researchers conduct many clinical trials to find drug combinations and treatment sequences that result in improved outcomes for patients who have breast cancer. Physicians talk with many patients about participating in a clinical trial.

Radiation Therapy

Radiation therapy involves the use of high-energy X-rays to kill cancer cells and shrink tumors. Radiation is used along with surgery to help improve the local control of inflammatory breast cancer. This treatment is most frequently administered after surgery but occasionally precedes surgical treatment. Radiation is delivered to the chest wall (or intact breast) and the draining lymph node regions. This treatment will decrease the risk of recurrence. The delivery of the radiation requires the careful consideration of each patient's body shape and normal tissues to ensure that the treatment is delivered in a safe manner. Those who undergo radiation consult with a radiation oncologist prior to starting treatment.

Hormone Therapy

Hormone therapy involves taking drugs that block estrogen from reaching breast cells to reduce the chance that cancer will recur. Hormone therapy may be appropriate. Mayo researchers conduct many clinical trials on hormone therapy, and patients may be offered the opportunity to participate. For premenopausal women whose tumor is sensitive to hormones, one hormonal therapy stops the hormone production in the ovaries. Options include surgical removal of the ovaries or medications that stop estrogen production. This approach may then be combined with pills that further help to reduce estrogen production.

Other Therapies

Mayo's clinical trials include experimental treatments, often unavailable elsewhere, which frequently lead to improved patient care for people worldwide. Mayo offers many experimental therapies, including Herceptin therapy. A Mayo physician can advise about experimental treatments.

Mayo Clinic Familial Cancer Program

In addition to these standard procedures, Mayo Clinic offers patients the opportunity to participate in the Familial Cancer Program, which helps to identify people at higher risk for breast cancer because of family history. A team of nurses, doctors and geneticists evaluate the patient and family. They determine potential cancer risk and develop a customized cancer-screening plan for families at increased risks. Consultations in the Familial Cancer Program are offered to those who have been diagnosed with cancer and to family members who have not had cancer.