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Inflammatory Breast Cancer

 

Mary Cianfrocca, D.O., is Director of Breast Medical Oncology at Banner MD Anderson Cancer Center.

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 Banner Health: Inflammatory Breast Cancer - Full Transcription

Audio: Music over opening titles and introduction.

Text:   Banner MC Anderson Cancer Center presents
  PATIENT POWER

Text:  Inflammatory Breast Cancer
  Mary Cianfrocca, D.O.
  Banner MD Anderson Cancer Center

Text:  Andrew Schorr
  Founder and Host, Patient Power
  Author, The Web-Savvy Patient

Image:  Andrew Schorr on- and off-camera

Audio:  “Hello. I’m Andrew Schorr from Patient Power. This program is sponsored by Banner MD Anderson Cancer Center. I want to talk to you about breast cancer. Most people, when they think about breast cancer, they understand that maybe it was developing over quite a long time and you have some time to make sure you get the treatment that’s right for you. But there is another kind of breast cancer, much less common, that is more urgent. And to help us understand that is Dr. Mary Cianfrocca. She is Director of Breast Medical Oncology at Banner MD Anderson Cancer Center. Doctor, thank you so much for being with us. ”

Images: Mary Cianfrocca, D.O. and Andrew Schorr on camera as each speak.

Dr. Cianfrocca Audio:  “Thank you so much for inviting me.”

Andrew Schorr Audio:  “Doctor, we’re talking about inflammatory breast cancer. How is that different?”

Text:  Mary Cianfrocca, D.O.
  Medical Oncology
  Banner MD Anderson Cancer Center

Dr. Cianfrocca Audio:  “Well, first off, I want to say that inflammatory breast cancer is a very rare type of breast cancer. It really represents less than five percent of breast cancer cases diagnosed in the United States each year. The way that it’s different is that it involves the dermal lymphatics, which is the lymphatics of the skin, and so it presents much differently than other types of breast cancer.”

Andrew Schorr Audio:  “So is this some type of much more urgent type of breast cancer? It’s sort of a five alarm fire? Getting early treatment is critical?”

Dr. Cianfrocca Audio:  ‘You’re absolutely correct, Andrew. This is a type of breast cancer that really needs to be diagnosed in a very timely fashion and recognized for what it is in the very beginning and not be mistaken for other conditions that are less urgent.”

Andrew Schorr Audio:  “What would be the signs of inflammatory breast cancer?”

Dr. Cianfrocca Audio:  “Inflammatory breast cancer is different than regular breast cancer in the fact that it generally presents with redness and swelling of the breast and does not necessarily present with a mass. You mentioned earlier that women are very attuned to looking for breast cancer. They go for their mammograms. They do self exams and look for lumps. And this is the type of breast cancer that typically pops up between mammograms. It occurs very rapidly and it doesn’t always involve a mass that you or your physician can feel or even a mass that’s seen on mammogram. So women have to be more attentive to different kinds of changes, like redness or swelling of the breast. And in inflammatory breast cancer, typically you’ll get a very characteristic appearance where the hair follicles of the breast get affected and that leads to an appearance of the skin that almost looks like the peel of an orange. And it’s actually referred to as, peau d’orange, which means orange peel.”

Andrew Schorr Audio:  “I understand, typically, breast cancer is not painful. But with inflammatory breast cancer, is their pain?”

Dr. Cianfrocca Audio:  “It occasionally can be. But it’s important to emphasize that it doesn’t necessarily have to be, that sometimes the woman will just notice redness and swelling without any real associated pain.”

Andrew Schorr Audio:  “So can this type particularly affect younger women?”

Dr. Cianfrocca Audio: “It can affect younger women but it can also affect older women too.”

Andrew Schorr Audio:  “So thinking about younger women, I imagine they may have some symptoms, go to the doctor, and both they and they doctor don’t really think of inflammatory breast cancer.”

Dr. Cianfrocca Audio:  “Misdiagnosis is a very large problem with inflammatory breast cancer for the reason that you eluded to in that some women and their physicians will think it’s an infectious cause for the symptoms rather than thinking about the possibility that it could be cancer. Also, in darker skinned individuals, particularly African Americans, sometimes the redness is not as apparent as it would be in a lighter skinned individual and you just have to be aware of the other changes—the swelling, the peau d’orange changes of the skin—and have really high index of suspicion that this could be something more than just infection.”

Andrew Schorr Audio:  “So it would seem that you’d have to push to make sure that you get the right test, the right evaluation, to rule out inflammatory breast cancer since it’s so serious.”

Dr. Cianfrocca Audio:  “Well, the way to rule it out is to start with imaging of the breast with a mammogram and ultrasound. And then, even if there’s no mass that can be seen on imaging, the skin itself can be biopsied to obtain a diagnosis. So even if there’s no mass that can be felt or that’s seen on imaging, a biopsy can still be done.”

Andrew Schorr Audio:  “If inflammatory breast cancer is, in fact, diagnosed, what happens next?”

Dr. Cianfrocca Audio:  “You mentioned a very important point earlier, that this is not like garden variety breast cancer where you really have time to go through the process. The patient really needs to start treatment as soon as possible. And the survival for inflammatory breast cancer has really improved markedly with the use of multimodality therapy. What that means is using all modalities of therapy, so chemotherapy, radiation therapy, surgery and hormonal therapy if the tumor is the type to respond to hormonal therapy. Generally speaking, with inflammatory breast cancer, unlike other types of breast cancer, the therapy almost always starts with chemotherapy.”

Andrew Schorr Audio:  “Would a woman continue to be taking medicines for an extended time?”

Dr. Cianfrocca Audio:  “That really depends on features of the cancer that would be found at the time of diagnosis. So, for example, a woman who has inflammatory breast cancer that responsive to changes in estrogen, that has estrogen or progesterone receptors, would go on after surgery and radiation to take a pill for five years or longer to try to prevent the cancer from coming back. So it really depends on features of the cancer that would be looked for at the time of diagnosis.”

Andrew Schorr Audio:  “Do we have any idea what causes inflammatory breast cancer? Does it run in families?”

Dr. Cianfrocca Audio:  “Well, breast cancer, in general, can run in families and you are correct. For the overwhelming majority of women with breast cancer, whether it be inflammatory or otherwise, we have no identifiable reason why they, as an individual, got breast cancer. The overwhelming majority of breast cancer is not associated with an identifiable genetic cause for the breast cancer. As you indicated before, inflammatory breast cancer does tend to occur in younger women. There also is an association between ethnicity and African American women are at increased risks. And also, there’s an increased risk with increased weight.”

Andrew Schorr Audio:  “So if your sister or your mother were diagnosed with inflammatory breast cancer, would you be at higher risk or at a higher risk for any type of breast cancer?”

Dr. Cianfrocca Audio:  “Yes. Having breast cancer in the family does put you at higher risk for having breast cancer, whether it be inflammatory breast cancer or other breast cancer.”

Andrew Schorr Audio:  “So the name of the game seems to be, if you have any of these kind of symptoms we described, to get checked and to have inflammatory breast cancer ruled out or get the treatment you need and deserve.”

Dr. Cianfrocca Audio:  “That’s a very important point, Andrew, and I think it extends to breast cancer in general. Women need to be very aware of any changes in their breasts and bring that to the attention of their medical professional. And be attuned to these kind of changes, even when they’re not the classic changes of a lump, which is what women are trained to find.”

Andrew Schorr Audio:  “So, after listening to this, I understand now that if a woman can get the right diagnosis, get treatment right away, perhaps through a specialist such as yourself, she can have the greatest hope for a longer life.”

Dr. Cianfrocca Audio:  “Oh, absolutely. And as I said before, survival rates are much better with inflammatory breast cancer when a multidisciplinary approach, including when a medical oncologist, radiation oncologist, surgical oncologist, is used

Andrew Schorr Audio:  “Dr. Mary Cianfrocca, Director of Breast Oncology at Banner MD Anderson Cancer Center in Gilbert Arizona, next to Phoenix, thank you so much for being with us on Patient Power.”

Dr. Cianfrocca Audio:  “Thank you so much for inviting me. It was a great opportunity to talk about a very important topic.”

Image:  Andrew Schorr addresses camera

Audio:  Closing music over conclusion and titles.

Andrew Schorr Audio:  “This is what we do, is connect you with leading experts who can help you understand conditions such as this very serious condition, inflammatory breast cancer, and you get the care that you need and deserve. For Patient Power and the Banner MD Anderson Cancer, I’m Andrew Schorr reminding you that knowledge can be the best medicine of all.’”

Text:   Banner MD Anderson Cancer Center presents
  PATIENT POWER

Text:  Banner MD Anderson Cancer Center
  Making Cancer History
  ©  2012 Banner Health

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