Inflammatory Breast Cancer (IBC) Treatment

For people whose cancer has not spread, or metastasized, treatment usually begins with chemotherapy to shrink the tumor followed by a mastectomy. Patients then receive radiation treatment to kill any cancer cells that were not visible to the naked eye during surgery. Depending on the disease’s molecular subtype, patients may also receive targeted therapy, including hormone therapy.

If a patient’s IBC has metastasized, or spread, she typically undergoes chemotherapy. If the tumor responds well to this treatment, she may then be eligible for a mastectomy. Additional treatments may include immunotherapy, radiation therapy and targeted therapy.

Chemotherapy

Chemotherapy uses powerful drugs to directly kill cancer cells, control their growth or relieve pain. It is often given to inflammatory breast cancer patients before surgery to shrink the tumor and simplify the procedure. It can also be given after surgery to kill any remaining cancer cells. Learn more about chemotherapy.

Surgery

Because inflammatory breast cancer may not have a distinctive breast lump, surgery to remove just the cancerous tissue (lumpectomy) is not possible. A complete mastectomy (removal of the entire breast) usually is needed to remove all the affected areas, including the previously involved skin.

The surgeon looks at lymph nodes close to the breast during surgery, and nearby lymph nodes are removed in most cases. Breast reconstruction usually is not recommended initially after surgery for IBC. It is best to wait until therapy has been completed and there is no evidence of disease.

Radiation therapy

Radiation therapy uses powerful beams of energy to kill breast cancer cells.

After chemotherapy and surgery, IBC patients may receive radiation therapy on the chest wall and lymph nodes. This treatment can reduce the risk of the disease coming back. Radiation therapy also may be used to treat IBC that has spread, to manage pain or to improve quality of life for patients who cannot have surgery. Typically post-mastectomy radiation for IBC is one to two times a day for 22-33 days, depending on the patient’s age and how well the chemotherapy worked.  Learn more about radiation therapy.

Targeted therapies

Cancer cells rely on specific molecules (often in the form of proteins) to survive, multiply and spread. Targeted therapies stop or slow the growth of cancer by interfering with, or targeting, these molecules or the genes that produce them.

In recent years, targeted therapy has become a major weapon in the fight against breast cancer. Breast cancer subtypes that once had poor prognoses are now highly treatable.

One type of targeted therapy is endocrine therapy, which is given to patients with hormone receptor-positive breast cancer. It is given after surgery for five to 10 years to prevent recurrence. Patients with the metastatic form of this disease are also given endocrine therapy in order to prevent disease progression.

Patients with HER2-positive breast cancer also receive targeted therapies. These patients may receive a different set of targeted therapy drugs both prior to and after surgery. Since about half of patients with HER2-positive breast cancer also have hormone receptor-positive tumors, they are also given endocrine therapy.

Metastatic triple-negative breast cancer can be treated with a targeted therapy focused on the TROP-2 protein produced by cancer cells. Learn more about targeted therapy.

Immunotherapy

Many cancer drugs directly kill cancer cells. Immunotherapy is different. It improves the ability of the patient’s own immune system to fight cancer.

At this time, immunotherapy has only been approved to treat breast cancer in limited cases. Studies are underway to learn how to use immunotherapy in additional situations. Learn more about immunotherapy.

Our treatment approach

Like all cancers, inflammatory breast cancer treatment is most successful when patients have an experienced care team. IBC makes up only 1%-5% of all breast cancer cases, so many doctors see only a handful of IBC patients during their career.

However, IBC is not rare to MD Anderson. As members of a top-ranked cancer center, our doctors treat hundreds of IBC patients every year, from the newly diagnosed to patients with metastatic or recurrent disease. This gives them incredibly deep skill and expertise to draw from when caring for patients.

This clinical experience and emphasis on research is leading to advances in the care of IBC. At MD Anderson, 98% of IBC patients who undergo a mastectomy have no detectible cancer cells in the margins of the surgical site. This greatly lowers the chances of the disease recurring locally. Combined with advances in medical oncology and radiation oncology, this level of care can lead to improved survival rates, studies indicate.

As a leading cancer center, MD Anderson can also offer clinical trials for patients at all stages of IBC, including those who are newly diagnosed and with previously treated/recurrent disease. Trials may offer patients drugs, such as targeted therapy and immunotherapy options.

Surgical Expertise

Like all surgeries, breast cancer surgery is most successful when performed by a specialist with a great deal of experience in the particular procedure. MD Anderson’s breast surgeons are among the most skilled and renowned in the world. They perform a large number of surgeries for inflammatory breast cancer each year, using the most-advanced techniques.

Surgeons at MD Anderson also are pioneering the use of specialized procedures for preventing/reversing lymphedema, a common side effect of standard surgery and radiation in breast cancer patients. IBC patients are at higher risk for lymphedema than the general breast cancer population. Learn about our reconstructive surgeons.