Diagnosis
Inflammatory breast cancer can be hard to diagnose because it is difficult to detect on a mammogram and its symptoms resemble those of other common conditions. Also, IBC is a very aggressive disease that can develop and progress between scheduled doctor appointments. To diagnose IBC, doctors look for the following criteria:
- Redness, swelling, dimpled skin, and/or a burning sensation in at least one-third of the breast.
- These symptoms developed rapidly and have been present for less than six months.
- Initial biopsy samples show malignant cells.
Your doctor may conduct the following imaging tests to help diagnose the disease and determine its stage:
Diagnostic Mammogram
A diagnostic mammogram is a detailed X-ray image of the breast. Inflammatory breast cancer may appear as thickened or denser tissue on a diagnostic mammogram.
Ultrasound
Ultrasounds bounce sound waves off of your internal organs in order to create echoes that form a picture. An ultrasound can help determine whether the cancer has spread to the lymph nodes.
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Magnetic resonance imaging (MRI)
MRI scans use radio waves and strong magnets instead of X-rays. MRIs produce very detailed images of the body and can detect IBC if the mammogram looks normal.
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Computed tomography (CT) scan
If other imaging tests show signs of cancer, your doctor may order a CT scan. A CT scanner rotates around your body taking pictures and produces detailed cross-sectional images of your body. It allows doctors to pinpoint the exact location of the tumor and check for cancer that may have spread.
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Bone Scan
A bone scan uses a radioactive substance to identify cancerous tissues in the bones. A bone scan provides a picture of all of the bones in the body, and allows doctors to detect small areas of cancer cells not visible on plain X-rays. The radioactive substance collects in these areas and illuminates them on the skeletal X-ray.
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Positron emission tomography (PET)/Computed tomography (CT) scan
A CT scan produces detailed cross-sectional images of the body and allows doctors to study specific areas, while a PET scan is used to view the entire body and detect any suspicious masses. An integrated PET-CT scan combines images from a PET scan and a CT scan to produce a more thorough image than either test alone. Both scans are performed at the same time using only one machine.
Your physical symptoms and imaging tests may all indicate IBC, but a biopsy and clinical appearance are the only way to know if you have the disease. Your surgeon will surgically remove a small sample of breast tissue and a pathologist will examine it under a microscope. A biopsy for IBC is usually a core needle biopsy guided by MRI or ultrasound. In this procedure, the doctor guides a large needle into the suspected cancer and removes a small cylinder of tissue. IBC can also sometimes be detected with a skin biopsy, in which the doctor removes a tissue sample from the skin.
