Over the past few weeks my breasts have become red, swollen and extremely itchy at the nipple. I did some research and found out about IBC. I went to a previously scheduled appointment with a dermatologist who did a biopsy. She also thought she felt a lump while she was doing an exam. In the meantime she gave me a steroid cream to use which has helped the flaking, but they're still red and itchy. I got the punch biopsy report back today which said it was either atopic or contact dermatitis. Another doctor checked the lump but wasn't sure if it was a lump or tissue since I'm only 19 years old. I'm scheduled for an ultrasound since the doctors won't do a mammo on a patient so young. My family has an EXTENSIVE history of cancer, specifically breast cancer. Are there any other procedures or tests to coincide with the biopsy diagnosis? I know IBC is fast acting and hard to diagnosis, so I just want to cover all my bases. Any suggestions?
19 makes breast cancer very, very unlikely even with a strong family history. The ultrasound, if it's normal, should completely alleviate all concerns you have. Inflammatory breast cancer should show both skin thickening (measurable by ultrasound) and breast edema (fluid in the breast tissues), which ultrasound is very good at detecting. If the ultrasound confirms the lump that the dermatologist thought she felt, it can be biopsied with a needle if the radiologist believes there is any chance is could be a cancer, although at your age it's far more likely to just be fibroglandular tissue reacting to normal hormones. Keep using the steroid cream until you get full resolution of the skin symptoms so that you can put your mind at ease. The medical community has a neverending arsenal of tests, including breast MRI, but I would avoid them in your situation unless strongly recommended by one of your doctors because everything you describe argues for atopy (allergy-dermatitis) and additional testing will no doubt uncover a slew of false alarms in hormonally active tissues at your age and result in needless additional anxiety and probably biopsies. The fact that you are so aware of breast cancer at your young age means you are going to catch it in time should it ever develop. Recommendations for screening in high risk patients is to start screening 5-10 years (I use 5) prior to the earliest age of diagnosis of one of your first degree relatives. For example, if your mother developed breast cancer at age 35, you should begin annual mammography and annual breast MRI at age 30. Very important though, is that if you should get a breast MRI, to do it during days 7-12 (approximately) of the menstrual cycle to minimize hormonal effects and false alarms. Day 1 is the first day you see bleeding.
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