Oncologists warn of aggressive type of breast cancer with unusual symptoms

COLUMBUS — Not all breast cancers begin with a lump, and during National Breast Cancer Awareness Month this October oncologists at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) want women to be aware of unusual symptoms associated with a particularly aggressive and deadly form of the disease known as inflammatory breast cancer.

Inflammatory breast cancer is a rare type of invasive cancer. It represents just one to five percent of all breast cancers and is often misdiagnosed because it mimics symptoms similar to a breast infection.

Those symptoms include:
• an orange peel-like texture or dimpling of skin;
• feeling of heaviness;
• tightening of the skin;
• engorgement of the breast; and
• infection-like redness.

“While many medical organizations no longer recommend routine breast self-exams, women should know that radical changes to the breast are not normal, and notifying a physician of these changes is very important. Some 30-40 percent of inflammatory breast cancers are diagnosed as stage 4 disease,” said Sachin Jhawar, MD, a radiation oncologist specializing in breast cancer at the OSUCCC – James’ Stefanie Spielman Comprehensive Breast Center. “It is important for women to recognize changes in both the appearance and feel of their breasts so that changes can be discussed quickly with a physician.” He notes that even in the medical community, physicians and providers are not accustomed to thinking about a red breast as a sign associated with inflammatory breast cancer because it is such a rare disease.

“Inflammatory breast cancer progresses and spreads rapidly within the breast and to the lymph nodes, so it can spread to other parts of the body more quickly than other types of breast cancer,” he said. “It can also be misdiagnosed as a dermatologic condition or infection because first-line healthcare workers may not be used to seeing this presentation of breast cancer. It’s important that we not only raise awareness of the subtle signs of this disease among individuals but also in the medical community so immediate action can be taken, and the affected individuals are able to move to the front of the line.”

Inflammatory breast cancer clinic offers specialized care

One of the few programs of its kind in the United States, the OSUCCC – James inflammatory breast cancer multidisciplinary clinic team includes surgical, medical and radiation oncologists, as well as breast radiologists, plastic/reconstructive surgeons, physical therapists and nurses who specialize in inflammatory breast cancer. The specialized care model has led to implementation of a formal best-practice clinical decision tree to help the OSUCCC – James medical team triage and rapidly respond to potential inflammatory breast cancer cases.

The team is working with frontline healthcare workers, including primary care physicians and obstetricians/gynecologists, to bring more awareness of this disease and the nuances of diagnosing and treating it. To learn more about breast cancer treatment at the OSUCCC – James, visit cancer.osu.edu/breastcancer.