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Is IBC possible after IDC?
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Is IBC possible after IDC?

I had 2 cm  invasive ductal cancer, with associated DCIS intermediate grade, both comedo and cribriform in Jan 2003 - WLE, and total axillary removal as out of sample 8 nodes, found 3 malignant. Total axillary removal found one more. 6 x FEC and 25 rads. Been on Arimidex since Feb 2004. Dx with Mondor's disease of same breast in 2005. BC breast has been grossly swollen, nipple gone south, aureola puffy and looks white as if no blood is getting there, with small lumps on it. Nipple does not retract.  The breast feels warm to the touch compared to other one. I last saw my bc surgeon (Onc discharged me after chemo and rads) at annual review in Feb 2007 and he said it is lymphodema. I have heard of lymphodema in the arms, but never in the breast. I am concerned that it might be ibc, but he said not. I am not due to see him again until Feb 2008. Should I be concerned?
Many thanks for your help and insight.
Liz.
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Avatar_n_tn
Hi,
You are basically concerned regarding the pathology of the breast at the moment. Is this Inflammatory carcinoma and if yes, can Inflammatory breast cancer occur after Infiltrating ductal carcinoma.
Basically, any lesion that occurs again in the breast which was previously treated for any carcinoma, would be considered to be a recurrence rather than a new pathology. INFLAMMATORY BREAST CANCER (IBC) is an advanced and accelerated form of breast cancer usually not detected by mammograms or ultrasounds. Inflammatory breast cancer requires immediate aggressive treatment with chemotherapy prior to surgery and is treated differently than more common types of breast cancer.
Typically, IBC symptoms may include:
    * One breast larger than the other
    * Red or pink skin on breast
    * Swelling of breast
    * Rash (entire breast or small patches)  
    * Orange-like skin texture (peau d’ orange) on breast  
    * Breast skin hot to the touch  
    * Pain and/or itchiness of breast  
    * Ridges or thickened areas of breast  
    * Nipple discharge  
    * Nipples that appear inverted or flattened  
    * Swollen lymph nodes under the armpit  
    * Swollen lymph nodes of the neck (sometimes)
MONDOR'S DISEASE
Mondor's disease of the breast is a rare benign breast condition characterized by thrombophelebitis of the superficial veins of the chest wall.

Hope the brief information of both would help you to certain extend.
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Avatar_f_tn
Many thanks for responding to my post, but it really doesn't answer my immediate question - can I get IBC after IDC?

Some of my symptoms correlate with the general symptoms, but not all of them. When I got IDC I had no palpable lump - it was found at normal 3 yrly mammo - my third. We only get them in England from age 50, and this was my 3rd. With hindsight, I wish I knew as much as I know now and would have gone privately for annual mammos.

I know in my mind and my heart that the breast that had cancer is not right, but I am nervous about getting another appt with my bc surgeon before my next annual review in Jan/Feb 2008, as he told me last Feb that it was lymphodema. I have not read anywhere on the net that you can get lymphodema in the breast - arms, yes.

I did know I had Mondor's disease before I had my surgeon take a look as I had researched it on the net. He said in his 30+ yrs as a bc surgeon he had never seen Mondor's in a patient with bc, but had otherwise. He even had the radiologists and radiographers come into the exam suite to take a look and have a feel as he said it so rare most of them have never seen it. I never "present" normally!

Would appreciate any further insight you may have.

By the way, I do "enjoy" your most erudite posts. Are you a retired doctor?

Regards,
Liz.
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Avatar_n_tn
Hi Liz,  I, too, have many of the symptoms you describe.  It has been a terrifying couple of weeks, to say the least.  I had a lympectomy Feb. 13th of this year and a couple of weeks ago woke with my breast (the surgical left breast) once again as big as it was the night before.  I did some research and realized I had at any one time 10 of the 12 or so symptoms for IBC.  (Barely) contolled panic followed.  IBC can be difficult to detect and so horribly invasive.  Within a 2 week period I saw my oncologist, had an MRI (looked okay), my surgeon and my radiologist. I was put on an antiobiotic (Cephalexin) and it has definitely lessened the swelling and firmness I had in my breast.  It still feels terribly 'heavy' and I have discomfort at times, expecially when I roll over in bed.  I've been told this could be some lymphedema or edema or some mastitis (I previously thought only nursing women got this)  My radiologist said I don't have one specific condition but several and we will probably never definitively know exactly what it (they) are.  I have been told the heavy feeling could last for some months and will slowly go away.  I was also told that only 1 or 2 women present with this problem during a years time. I was also told that a correlation has been noticed (in the radiologist practice) that this might be related to the Arimidex I am taking.  My nipple and areola are flesh colored (almost no color left) and my nipple had got so flat I could no longer grab hold of it.  I had lots of the 'orange peel' and thickened skin (probably fluid 'pooling').  My breast is warm (though not hot) to the touch.  At times I had a 4" or so stripe of red down one side on my breast.  All of these symptoms have improved with the antiobiotic. (for the exception of the color)  I have a couple days remaining of my antiobiotic and I'm hoping all the symtoms (symptoms) stay at bay when it is gone.
That's probably w-a-y more info than you wanted (lol) but I know the waiting is the WORSE!  I hope you go in this week and at least ask to try an antibiotic.  At least you will be doing something while you're waiting.  Have you had an MRI yet?  Today is the first day I really feel optimistic after seeing my Radiologist yesterday.  I have certainly learned that a woman has to be persistant (definitely not my personality!) and keep asking questions until you are convinced that they have the right diagnosis.  Every woman is different.  And, I've also learned that some of the symptoms can come and go.  I felt like I could have been reading my own report when I read your entry and I certainly feel good about your prognosis but I would definitely keep asking questions.  This is your life.  If you need to step on a few toes at times, so be it.  For 2+ weeks I've told myself, the worse case scenerio is that I just sit back and 'wait and see' and I find out too late that my gut feeling was right all along.  I've never in my life wanted so badly to be wrong!  I see my surgeon again this following Wednesday.  I urge you to see your doctor as soon as possible.  Ask is he can squeeze you in.  And, bring your paperwork with you that you have found online.  (Most) of my doctors are glad I've done my 'homework'.
Oh, and, yes, breast lymphedema is much more widespread that we realize.  (perhaps because it can be hidden under a large top, etc)  I've included a link I found and if you do a google search for breast lymphedema, you'll find other sources as well.
Certainly not the road I would have chosen but it is nice to know I'm not out there walking it totally alone.  I wish you all the best.  Nancy

http://www.vermontwoman.com/articles/1103/bellisse.shtml
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Avatar_n_tn
Hi,
Thanks for your feedback.
Not a retired personnel, yet active into my primes
To answer your query about can I get IBC after IDC, it would be difficult to predict about this. The can be possibility of it but the incidence of occurrence is rare.

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