WINNEMUCCA - It used to be common knowledge that breast cancer always presented itself as lumps in the breast. While many forms of breast cancer do present that way, and any unusual lumps in the breast should still be reported to a primary care physician as soon as possible, modern medical professionals advise taking a broader approach to self exams.
"I am concerned that people know about Inflammatory Breast Cancer," said Nurse Bobbi Gillis.
Gillis is a Nurse Navigator and the Breast Program Coordinator for Renown Institute for Cancer in Reno, a hospital that serves Winnemucca patients.
"Inflammatory Breast Cancer is an aggressive cancer," she explained.
Inflammatory Breast Cancer is rare, but Gillis pointed out that in addition to being very aggressive, this type of cancer is increasingly found in women who may think of themselves as too young to develop breast cancer.
"Inflammatory Breast Cancer makes up only 1 percent to 3 percent of breast cancer cases, but it seems to occur a lot in women younger than 50," she said.
Gillis added that this type of cancer's resemblance to an infection often leads people to visit their primary care doctor to be treated for infection.
"It presents as an infection in the breast. The person will notice a swelling of the breast. The coloring of the breast is reddened. The skin has an orange peel texture. We don't really see a distinct lump," she said. "A woman will come in thinking she has an infection, but antibiotics don't work,"
Gillis added, "I recommend going to your regular doctor with any unusual swelling in the breast, but if antibiotics don't work, go back. Be your own advocate for your health."
Determining whether a swollen area on or near the breast is a symptom of Inflammatory Breast Cancer or a normal variation requires detailed knowledge of one's own breasts.
"Be familiar with your breasts," Gillis said. "I recommend examining them right after a clinical exam that comes out normal. You know that anything that is there at that point is supposed to be there."
"Lumps and bumps in the breast are normal," she added. "What you are looking for is something in one breast that wasn't there before. Report any changes in the breast that you see, including any changes in the size and shape of the breast, and any changes in the nipple."
Gillis urged women to be familiar with the entire area of the body around the breast, noting that breast tissue extends beyond what we call "breasts" in everyday speech.
When looking for changes, it is important to examine the area up above the breasts toward the collarbone, and to the side of the breast, up under the arm as well as the area that is covered by a bra or bathing suit top.
"When you visit your doctor, report any change in the appearance of your breasts, and report any swelling above what you think of as the breast, up into the armpit," she advised.
Dr. Deepa Mocherla, an oncologist with Renown, described the treatment process a patient could expect should they be diagnosed with Inflammatory Breast Cancer.
"Patients are referred to a specialist who will be doing a complete history and physical exam, labs, and other testing," she explained. "Based on the physician's findings, further testing may be needed to look for spread of cancer by imagines studies such as CT scan, bone scans and/or PET/CT scans Patients are referred to other specialists who may be involved in their care. If there is concern for possible hereditary causes for breast cancer, genetic counseling is generally recommended. A multidisciplinary approached is used and a detailed panel discussion usually takes place to discuss and plan treatment based on the specifics of the patient."
Dr. Mocherla further explained that treatment for Inflammatory Breast Cancer will involve numerous medical appointments.
"The patient will have frequent visits to the oncologist," she said. "Initial consultation is usually one hour. Follow up visits are usually 15-30 minutes. Once treatment is started, the visits are usually every 2 to 3 weeks based on the chemotherapy. The patient will need labs and follow up prior to each treatment. Once treatment is completed, the patient will need continued follow ups every 3-6 months with labs and yearly mammograms."
Dr. Mocherla further explained that treatment for this type of cancer will require appointments with more than one medical professional.
"Treatment of inflammatory breast cancer involves a multidisciplinary approach involving various subspecialists such as surgery, reconstruction surgery, radiation oncology, and medical oncology," she said. "For cancer that has not spread, chemotherapy prior to surgery is generally preferred in inflammatory breast cancer. This is followed by surgery, radiation and further therapy with either chemotherapy or endocrine therapy. If the cancer has spread, then patients are generally on continuous chemotherapy and/or endocrine therapy."
Because this form of breast cancer is so aggressive, Dr. Mocherla urged anyone diagnosed with it to both seek treatment and to return for all available follow-up care and screenings.
"Inflammatory breast cancers are rare and are aggressive in nature," she said. "They generally grow very quickly, can be painful and cause a lot of changes in the breast. These cancers carry poor prognosis and have a high risk of coming back. The risk of them coming back is higher if the tumor was found to be in the lymph nodes or if initially diagnosed with a higher stage of cancer. If this tumor comes back, it can either come back in the other beast or as metastatic disease, in which case the tumor has spread. Due to this risk, patients must continue to follow up with their specialists and have routine labs and imaging."
Despite the current poor prognosis and aggressive nature of Inflammatory Breast Cancer, Dr. Mocherla noted that researchers are studying the disease to improve treatment options and survival rates.
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