Inflammatory Breast Cancer

Inflammatory breast cancer (IBC) is rare and accounts for only 1-5% of all breast cancers. Although it is often a type of invasive ductal carcinoma, it differs from other types of breast cancer in its symptoms, outlook, and treatment. IBC has symptoms of inflammation like swelling and redness, but infection or injury do not cause IBC or the symptoms. IBC symptoms are caused by cancer cells blocking lymph vessels in the skin causing the breast to look "inflamed."

Symptoms include breast swelling, purple or red color of the skin, and dimpling or thickening of the skin of the breast so that it may look and feel like an orange peel. Often, you might not feel a lump, even if it is there. If you have any of these symptoms, it does not mean that you have IBC, but you should see a doctor right away.

How is inflammatory breast cancer different from other types of breast cancer?

Inflammatory breast cancer differs (IBC) from other types of breast cancer in several ways:

  • IBC doesn't look like a typical breast cancer. It often does not cause a breast lump, and it might not show up on a mammogram. This makes it harder to diagnose.
  • IBC tends to occur in younger women (younger than 40 years of age).
  • African-American women appear to develop IBC more often than white women.
  • IBC is more common among women who are overweight or obese.
  • IBC also tends to be more aggressive—it grows and spreads much more quickly—than more common types of breast cancer.
  • IBC is always at a locally advanced stage when it’s first diagnosed because the breast cancer cells have grown into the skin. (This means it is at least stage III.)
  • In about 1 of every 3 cases, IBC has already spread (metastasized) to distant parts of the body when it is diagnosed. This makes it harder to treat successfully.
  • Women with IBC tend to have a worse prognosis (outcome) than women with other common types of breast cancer.

Signs and symptoms of inflammatory breast cancer

Inflammatory breast cancer (IBC) causes a number of signs and symptoms, most of which develop quickly (within 3-6 months), including:

  • Swelling (edema) of the skin of the breast
  • Redness involving more than one-third of the breast
  • Pitting or thickening of the skin of the breast so that it may look and feel like an orange peel
  • A retracted or inverted nipple
  • One breast looking larger than the other because of swelling
  • One breast feeling warmer and heavier than the other
  • A breast that may be tender, painful or itchy
  • Swelling of the lymph nodes under the arms or near the collarbone

illustration showing a breast with inflammatory breast cancer

Tenderness, redness, warmth, and itching are also common symptoms of a breast infection or inflammation, such as mastitis if you’re pregnant or breastfeeding. Because these problems are much more common than IBC, your doctor might suspect infection at first as a cause and treat you with antibiotics.

This may be a good first step, but if your symptoms don’t get better in 7 to 10 days, more tests need to be done to look for cancer. The possibility of IBC should be considered more strongly if you have these symptoms and are not pregnant or breastfeeding, or have been through menopause.

IBC grows and spreads quickly, so the cancer may have already spread to nearby lymph nodes by the time symptoms are noticed. This spread can cause swollen lymph nodes under your arm or above your collar bone. If the diagnosis is delayed, the cancer can spread to distant sites.

If you have any of these symptoms, it does not mean that you have IBC, but you should see a doctor right away. If treatment with antibiotics is started, you’ll need to let your doctor know if it doesn't help, especially if the symptoms get worse or the affected area gets larger. Ask to see a specialist (like a breast surgeon) or you might want to get a second opinion if you’re concerned.

How is inflammatory breast cancer diagnosed?

Imaging tests

If inflammatory breast cancer (IBC) is suspected, one or more of the following imaging tests may be done:

Sometimes a photo of the breast is taken to help record the amount of redness and swelling before starting treatment.

Biopsy

Breast cancer is diagnosed by a biopsy, taking out a small piece of the breast tissue and looking at it in the lab. Your physical exam and other tests may show findings that are "suspicious for" IBC, but only a biopsy can tell for sure that it is cancer.

Tests on biopsy samples

The cancer cells in the biopsy will be examined in the lab to determine their grade.

They will also be tested for certain proteins that help decide which treatments will be helpful. Women whose breast cancer cells have hormone receptors are likely to benefit from treatment with hormone therapy drugs.

Cancer cells that make too much of a protein called HER2 or too many copies of the gene for that protein may be treated by certain drugs that target HER2.

Stages of inflammatory breast cancer

All inflammatory breast cancers start as Stage III (T4dNXM0) since they involve the skin. If the cancer has spread outside the breast to distant areas it is stage IV

For more information, read about breast cancer staging.

Survival rates for inflammatory breast cancer

Inflammatory breast cancer (IBC) is considered an aggressive cancer because it grows quickly, is more likely to have spread at the time it’s found, and is more likely to come back after treatment than other types of breast cancer. The outlook is generally not as good as it is for other types of breast cancer.

Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. They can’t tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.

Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they can’t predict what will happen in any particular person’s case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.

What is a 5-year relative survival rate?

A relative survival rate compares women with the same type and stage of breast cancer to women in the overall population. For example, if the 5-year relative survival rate for a specific stage of breast cancer is 70%, it means that women who have that cancer are, on average, about 70% as likely as women who don’t have that cancer to live for at least 5 years after being diagnosed.

Where do these numbers come from?

The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute (NCI), to provide survival statistics for different types of cancer.

The SEER database tracks 5-year relative survival rates for breast cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages (stage 1, stage 2, stage 3, etc.). Instead, it groups cancers into localized, regional, and distant stages:

  • Localized: There is no sign that the cancer has spread outside of the breast.
  • Regional: The cancer has spread outside the breast to nearby structures or lymph nodes.
  • Distant: The cancer has spread to distant parts of the body such as the lungs, liver or bones.

5-year relative survival rates for inflammatory breast cancer

(Based on women diagnosed with inflammatory breast cancer between 2009 and 2015.)

SEER Stage 5-year Relative Survival Rate
Regional 52%
Distant 18%
All SEER Stages 39%

Understanding the numbers

  • Women now being diagnosed with inflammatory breast cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on women who were diagnosed and treated at least four to five years earlier.
  • These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later on if the cancer grows, spreads, or comes back after treatment.
  • These numbers don’t take everything into account. Survival rates are grouped based on how far the cancer has spread, but your age, overall health, how well the cancer responds to treatment, tumor grade, and other factors can also affect your outlook.

*SEER = Surveillance, Epidemiology, and End Results 

Treating inflammatory breast cancer

Inflammatory breast cancer (IBC) that has not spread outside the breast or nearby lymph nodes is stage III. In most cases, treatment is chemotherapy first to try to shrink the tumor, followed by surgery to remove the cancer. Radiation is given after surgery, and, in some cases, more treatment may be given after radiation. Because IBC is so aggressive, breast conserving surgery (lumpectomy) and sentinel lymph node biopsy are typically not part of the treatment.

IBC that has spread to other parts of the body (stage IV) may be treated with chemotherapy, hormone therapy, and/or with drugs that targets HER2.

For details, see Treatment of Inflammatory Breast Cancer.

The American Cancer Society medical and editorial content team

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.

American Joint Committee on Cancer. Breast. In: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer; 2017:589. 

Curigliano G. Inflammatory breast cancer and chest wall disease: The oncologist perspective. Eur J Surg Oncol. 2018 Aug;44(8):1142-1147.

Hance KW, Anderson WF, Devesa SS, Young HA, Levine PH. Trends in inflammatory breast carcinoma incidence and survival: the Surveillance, Epidemiology, and End Results program at the National Cancer Institute. J Natl Cancer Inst. 2005;97:966−975.

Hennessy BT, Gonzalez-Angulo AM, Hortobagyi GN, et al. Disease-free and overall survival after pathologic complete disease remission of cytologically proven inflammatory breast carcinoma axillary lymph node metastases after primary systemic chemotherapy. Cancer. 2006;106:1000−1006.

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 July 23, 2019.

National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Breast Cancer. Version 2.2019. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf on July 23, 2019.

Overmeyer B and Pierce LJ. Chapter 59: Inflammatory Breast Cancer. In: Harris JR, Lippman ME, Morrow M, Osborne CK, eds. Diseases of the Breast. 5th ed. Philadelphia, Pa: Lippincott-Williams & Wilkins; 2014.

Schlichting JA, Soliman AS, Schairer C, Schottenfeld D, Merajver SD. Inflammatory and non-inflammatory breast cancer survival by socioeconomic position in the Surveillance, Epidemiology, and End Results database, 1990-2008. Breast Cancer Res Treat. 2012 Aug;134(3):1257-68. Epub 2012 Jun 26.

Scott LC, Mobley LR, Kuo TM, Il'yasova D. Update on triple-negative breast cancer disparities for the United States: A population-based study from the United States Cancer Statistics database, 2010 through 2014. Cancer. 2019 Jul 8. doi: 10.1002/cncr.32207. [Epub ahead of print].

Taghian A, El-Ghamry MN and Merajver SD. Inflammatory breast cancer: Clinical features and treatment. UpToDate website. https://www.uptodate.com/contents/inflammatory-breast-cancer-clinical-features-and-treatment. Last updated Sept 26, 2018. Accessed Aug 5, 2019.

Yang WT, Le-Petross HT, Macapinlac H, Carkaci S, Gonzalez-Angulo AM, Dawood S, Resetkova E, Hortobagyi GN, Cristofanilli M: Inflammatory breast cancer: PET/CT, MRI, mammography and sonography findings. Breast Cancer Res Treat. 2008 Jun;109(3):417-26. Epub 2007 Jul 26. Review.

Last Medical Review: September 20, 2019 Last Revised: September 20, 2019

American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.