Misdiagnosis

My mother was diagnosed, pre-biopsy, as having inflammatory breast cancer. Her symptoms were textbook, and the mammogram and ultrasound indicated ibc. Her symptoms did not respond to antibiotics and have remained the same. The doctor took two biopsy samples and called with the results. The samples indicate that she has invasive duct cell carcinoma with ductal in situ. Are ibc symptoms present in other types of cancer? If not, what else could these symptoms indicate? My first thought was to have another biopsy performed to confirm the diagnosis, but that will be highly unpleasant and painful for my mother, who bled profusely during the procedure. I am thrilled to be able to hope that it isn't ibc, but the treatment for ibc is chemo followed by surgery, while the other form is treated first with surgery.

Why would the doctors tell her it's ibc when it isn't? What else could cause those symptoms?

[CCF-RN,MSN-JS]

Dear katmcginty, Inflammatory breast cancer (IBC) is called inflammatory because the initial clinical symptoms are usually a redness, and warmth in the skin of the breast, often without a distinct lump.  A peau d'orange appearance of the skin (like a skin of an orange peel) is also a common sign.  When a biopsy is done the dermal layer of skin may be part of the biopsy to determine if cancer cells have infiltrated the lymph vessels of the skin, which is what makes the skin red.  Depending on what the biopsy was of, if it included the skin, inflammatory breast cancer may or may not be the diagnosis stated on the pathology report.  However, if the presenting symptoms were suspicious for IBC, the dermal skin was not included in the biopsy, the cancer may be treated as IBC.  If the skin was biopsied and no infiltration of these lymphatic vessels of the skin was noted, the inflammatory symptoms may be attributed to another problem such as mastitis, cellulitis, or infection, and the cancer may not be treated as IBC.  

Discuss your concerns with doctors that are working with your mother, they can hopefully put all of the findings into context for you.

[janz]

Since I've had IBC (inflammatory breast cancer) and belong to two on-line support groups for IBC I've heard these reasons many times for a breast with problems.  I can only say that although IBC is uncommon compared to the more standard breast cancers, it is misdiagnosed and misreported to the cancer registries.  IBC doesn't usually present as a lump, doesn't show up on a mammogram or an ultrasound and many times it is missed on biopsy.  Therefore, IBC is more often than not diagnosed by clinical presentation.  I would suggest that you go to www.ibcresearch.org and do some reading.  IBC is treated with neo-adjuvant chemo (chemo first), surgery, more chemo and radiation.  It's very aggressive and can be fast spreading.  Anyone with unusual breast symptoms that are unexplained should seek a breast specialist that is well versed in IBC.