10 Tests to Diagnose Inflammatory Breast Cancer

Inflammatory breast cancer (IBC) is a rare type of breast cancer; it is an aggressive breast cancer which spreads quickly to other parts of the body through lymphatic system and blood circulation. Most of the inflammatory breast cancers are invasive ductal carcinomas, which means these cancer cells originate from the cells of the ducts which produce milk. These cancer cells can spread beyond the ducts and block the lymphatic vessels in the overlying skin of the breast leading to blockage of lymph fluid and collection of fluid in the breast. This causes red, swollen breast, thus giving the name inflammatory breast cancer.

10 Tests to Diagnose Inflammatory Breast Cancer

10 Tests to Diagnose Inflammatory Breast Cancer

Diagnosis can be made through symptoms and physical examination of the breast and lymph nodes. Tests are needed to confirm the diagnosis.

  1. Diagnostic Mammography: Mammogram is an x-ray test of the breast. It shows most of the breast lumps.
  2. Ultrasound Scan: Ultrasound for inflammatory breast cancer scan can differentiate the solid mass (it can be a cancer) from fluid filled cysts.
  3. Magnetic Resonance Imaging (MRI): If there is a lump the size of the lump can be measured well with the MRI test. When a contrast is given it gives a clear picture of the cancer. After the diagnosis of cancer MRI can give additional information about the spread of the cancer in that breast and if there is cancer in the other breast can also be visualized.
  4. Biopsy: Biopsy is the only test to confirm whether the lump is a cancer or not. Piece of tissue from the lump is taken and visualized under the microscope to check if there are cancer cells. There are several types of biopsies
  5. Fine Needle Aspiration Biopsy (FNA): This is the least invasive test to obtain a biopsy. If the operator and cytologist are experienced it gives accurate results. However, false negatives occur through errors in sampling and it cannot differentiate in situ disease from invasive cancer.
  6. Core Needle Biopsy: A larger needle is used to remove a large piece of tissue from the lump. A vacuum-assisted biopsy can remove several samples of tissue. In inflammatory breast cancer there might not be a single main tumor therefore; several tissue samples from different places are needed to diagnose cancer. Local anesthesia is given to numb the area before the procedure. This is better than FNA to diagnose inflammatory breast cancer.
  7. Skin Punch Biopsy: Since, inflammatory breast cancer cells are found in the lymph vessels in the skin, a skin punch biopsy can identify cancer cells in the skin.
  8. Surgical Biopsy: The patient undergoes a breast surgery to remove the either part of the lump or entire lump. This is not usually practiced because it is best to do surgery after the definitive diagnosis of cancer. But, this is done if the core biopsy does not give a proper diagnosis.
  9. Image-Guided Biopsy: When a lump is seen on imaging studies but cannot be located through physical examination a biopsy can be done with the help of imaging studies. Mammogram, ultra sound scan or MRI can be used to direct the needle to the lump and FNA, core or vacuum-assisted biopsy can be done. Titanium clip is placed on the area where the biopsy was taken to identify the lump in case surgery is needed. This is a good way to take a biopsy for inflammatory breast cancer because imaging can show the best place to take the biopsy.
  10. Tests To Identify Metastasis To Other Organs
  • CT scan/ PET scan – chest/abdomen
  • Bone scan
  • Liver function test

Summary

Inflammatory breast cancer (IBC) is a rare type of breast cancer. Diagnosis can be made through symptoms and physical examination of the breast and lymph nodes. Tests are needed to confirm the diagnosis. The imaging tests are MRI, mammogram, and ultrasound scan. MRI gives more information about the spread, size of the tumor and if there is cancer in the other breast. Biopsy is the definitive test to diagnose cancer; core biopsy is the best technique to get the biopsy for inflammatory breast cancer. Skin punch biopsy also can be done to identify cancer cells in the skin if lump is not felt image-guided biopsy can be done.

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