From time to time, you might get a rash on your breast. Most of the time, it’s nothing serious. It could be a reaction to heat or detergent or a skin condition like eczema. But in rare cases, changes in the skin on your breast could be a warning sign of inflammatory breast cancer (IBC), a fast-growing and aggressive form of breast cancer.
When you know the difference between a common skin issue and something more serious, you can take the right steps. Here’s what to look for.
What is inflammatory breast cancer (IBC)?
Inflammatory breast cancer is a rare and aggressive type of breast cancer. Only 2% to 4% of breast cancer cases are IBC. Instead of forming a lump like many types of breast cancer, IBC quickly makes the breast look red, swollen or inflamed, often in days or weeks.
“This happens as the cancer cells block lymph vessels in the skin and soft tissue,” said Manpreet Chadha, MD, a breast medical oncologist with Banner MD Anderson Cancer Center.
Most of the time, IBC is diagnosed at a later stage (at least stage III) since the cancer has already spread to the skin and nearby lymph nodes. In about one out of three cases, IBC has already metastasized, meaning it has spread to other parts of the body.
IBC often affects younger women and can be mistaken for a rash or infection. That’s why it’s important to be aware of the signs and act quickly.
What are common causes of a rash on the breast?
Not every rash means something serious is going on. These are some common and harmless causes of a breast rash:
- Heat rash: From sweating or friction
- Eczema or other skin conditions: These can cause itching and dryness
- Allergic reactions: Soaps, lotions or laundry detergent may trigger a rash, especially if you have sensitive skin
- Insect bites: Mosquito or bug bites can cause irritation and itching
- Fungal or bacterial infections: Often found in skin folds and may cause redness or feel uncomfortable
“These other causes of skin rash can be related to an infection or an allergy,” Dr. Chadha said. These types of rashes are usually temporary, and you can treat them with home remedies or over-the-counter (OTC) medication.
How can you tell if it’s a rash or a sign of inflammatory breast cancer?
It can be hard to tell the difference between a simple rash and IBC. But there are some signs that can help you know when it’s time to take it more seriously.
Common rash
- Itchy and dry
- Often on both breasts
- Goes away in a few days
- No other changes in the breast
Inflammatory breast cancer
- Warm, swollen and painful
- Usually affects one breast
- Gets worse quickly
- Skin may look like an orange peel
“A persistent redness with thickened skin that covers at least one-third of the breast and is getting worse quickly should be a sign to seek immediate medical attention,” Dr. Chadha said.
What symptoms of inflammatory breast cancer should you watch for?
“You should seek immediate medical attention if you have a rash that is not improving,” Dr. Chadha said.
Talk to a health care provider right away if you notice:
- Redness: Pink, red or dark colored area on the breast.
- Swelling or firmness: Fluid buildup makes the breast look and feel larger.
- Warmth: The breast feels hot.
- Thickened skin: Skin may look dimpled or pitted like an orange peel.
- Pain or tenderness: The breast feels uncomfortable.
- Inverted or retracted nipple: The nipple pulls inward or lies flat against the areola.
- Discharge: Fluid may come from the nipple.
- Rapid changes: The breast size or shape suddenly shifts.
“Some people may also have enlarged lymph nodes in their armpit or in the neck around the collarbone,” Dr. Chadha said.
When should you seek medical care?
You should contact a health care provider if:
- A rash doesn’t improve in a few days.
- You notice swelling or skin changes, especially if they happen quickly.
- Your breast looks or feels different.
- You have pain, warmth or unusual discharge.
- Your symptoms are getting worse or not improving.
Even if it turns out to be something minor, it’s better to get it checked.
How is IBC diagnosed and treated?
IBC is diagnosed based on skin or nipple changes, swelling and redness that appeared in six months or less. A biopsy can check for cancer cells. Your provider may recommend an MRI or CT scan to see if the cancer has spread.
Unlike many types of breast cancer, IBC may not show up on a mammogram. If you’ve recently had a mammogram, don’t assume your symptoms can’t be breast cancer. IBC is aggressive, so early diagnosis and fast treatment can make a big difference in your outcome.
Treatment for IBC depends on how advanced the cancer is. You may need:
- Chemotherapy to shrink the cancer
- Surgery to remove the affected tissue
- Radiation therapy to destroy any remaining cancer cells
- Targeted therapies to help stop or slow cancer growth
- Immunotherapy to help improve the immune system’s ability destroy the cancer
A team of people will be involved in your care. “Medical oncology, surgical oncology, radiation oncology, as well as plastic surgery, genetics, lymphedema, physical medicine and rehabilitation are important components for care,” Dr. Chadha said.
You might also qualify for clinical trials. “Trials for monitoring and treatment of inflammatory breast cancer are exploring new treatment options for this aggressive disease,” Dr. Chadha said.
Breast cancer care at Banner MD Anderson
An early multidisciplinary approach is important for treating IBC. Banner MD Anderson specializes in diagnosing and treating complex conditions like IBC with advanced imaging and treatment planning.
While most breast rashes aren’t signs of cancer, IBC can get worse quickly. If you’ve noticed unusual breast changes or symptoms, don’t wait. Speak with your health care provider or an expert at Banner Health to talk about your concerns.
