Most people with inflammatory breast cancer will have a combination of treatments. This includes systemic therapy, which are medicines given intravenously (into a vein in the arm, hand or chest) or by mouth to target the entire body such as chemotherapy, targeted therapy, immunotherapy and hormonal therapy. In addition to systemic therapy, surgery and radiation therapy may be needed.
Chemotherapy
For most people with inflammatory breast cancer, treatment usually starts with chemotherapy. Chemotherapy involves using drugs to control or kill cancer cells within the breast and any that may have spread to other parts of the body and cannot be detected using routine tests. The drugs are usually given through a drip in the arm. Chemotherapy is usually given in cycles every week or over a number of weeks, often over 3–6 months.
Chemotherapy may be used with other breast cancer treatments during or after chemotherapy – this includes treatments targeting HER2 receptors or immunotherapy which are usually given as a drip into the vein, or hormonal therapy, usually given as tablets. The choice of drugs depends on the exact pathology profile of the breast cancer cells that have been removed.
Targeted therapies
Targeted therapies are drugs that stop the growth of particular types of cancer cells. Targeted therapies are only suitable for some women. They may be used alongside other breast cancer treatments for inflammatory breast cancer.
Hormonal therapies
Hormonal therapies are drugs used to treat women who have hormone receptors on their breast cancer cells. Hormonal therapies may be used alone or with other breast cancer treatments for inflammatory breast cancer.
Breast surgery
Breast surgery is used to treat inflammatory breast cancer if the cancer responds well to chemotherapy – that is, if almost all the initial signs and symptoms disappear after chemotherapy.
Surgery for inflammatory breast cancer usually involves complete removal of the breast (mastectomy) and removal of lymph nodes from the armpit.
Breast reconstruction may be possible once all initial treatments have been completed but this should be discussed with the treating doctors.
Radiotherapy
Radiotherapy is almost always used during treatment for inflammatory breast cancer. Radiotherapy may be used before or after surgery or instead of surgery, depending on how the cancer has responded to chemotherapy. Radiotherapy uses X-rays (controlled doses of radiation) to destroy cancer cells in the breast or chest wall. It may also be directed to the lymph nodes in the armpit and in the base of the neck. Radiotherapy is usually given once a day, 5 days a week for 3–6 weeks.
The treatment plan may need to be adjusted depending on the response of the cancer to the different treatments and the extent of cancer in the body. Ask as many questions as you need to about the treatments recommended for you and the options available.
What follow-up care can be expected?
Once the initial treatment is finished, regular follow-up appointments with your specialist or general practitioner are recommended. Follow-up after treatment for inflammatory breast cancer usually involves a regular physical examination and annual mammogram with or without an ultrasound. Other tests such as blood tests or bone scans are not routinely needed during follow-up unless there is concern that the cancer has spread outside the breast.
Questions to ask the doctor
Some people want to know everything possible about their breast cancer and treatment. Others don’t want to know as much. Ask your doctors as many questions as you need to – you may find it useful to write questions down before your next visit. For more information about management of breast cancer in general see Guide to Best Cancer Care - Breast cancer
