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Treatments and drugs
By Mayo Clinic staffTreatment for inflammatory breast cancer often begins with chemotherapy, followed by surgery and radiation therapy. After these treatments, other treatments may be used if tests of your cancer cells reveal that you may benefit from additional treatments.
Chemotherapy
Chemotherapy uses chemicals to kill cancer cells. You receive chemotherapy drugs through a vein (intravenously), in pill form or both. Chemotherapy is often used prior to surgery for inflammatory breast cancer. This presurgical treatment, referred to as neoadjuvant therapy, aims to shrink the cancer before the operation and increase the chance that surgery will be successful. Chemotherapy can also be used after surgery.
Surgery
After chemotherapy, women with inflammatory breast cancer usually have an operation to remove the affected breast (mastectomy). Most women with inflammatory breast cancer undergo a modified radical mastectomy, which involves removing the entire breast and several nearby lymph nodes. The lymph nodes are tested for signs of cancer.
Radiation therapy
Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. During radiation therapy, you lie on a table while a large machine moves around you, directing the energy beams to your cancer. Radiation therapy can be used after chemotherapy and surgery to kill any cancer cells that might remain around your breast and under your arm.
Hormone therapy
If your inflammatory breast cancer is sensitive to hormones, your doctor may recommend hormone therapy. Hormone therapy treatments can include:
- A medication that blocks hormones from attaching to cancer cells. Tamoxifen is a type of drug called a selective estrogen receptor modulator (SERM). SERMs act by blocking any estrogen present in the body from attaching to the estrogen receptor on the cancer cells, slowing the growth of tumors and killing tumor cells. Tamoxifen can be used in both pre- and postmenopausal women.
- Medications that stop the body from making estrogen after menopause. Called aromatase inhibitors, these drugs block the action of an enzyme that converts androgens in the body into estrogen. These drugs are effective only in postmenopausal women. Aromatase inhibitors include anastrozole (Arimidex), letrozole (Femara) and exemestane (Aromasin).
Targeted therapy
Targeted therapies kill cancer by focusing on the cancer cells' particular vulnerabilities. For inflammatory breast cancer cells with a certain genetic mutation, the medication trastuzumab (Herceptin) may be a treatment option. Trastuzumab targets a protein called HER2 that helps some inflammatory breast cancer cells grow and survive. If your inflammatory breast cancer cells make too much HER2, trastuzumab may help block that protein and cause the cancer cells to die. Trastuzumab can be combined with chemotherapy and used before and after surgery.
- Breast cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Feb. 9, 2012.
- Inflammatory breast cancer: Questions and answers. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Sites-Types/IBC. Accessed Feb. 9, 2012.
- Dawood S, et al. International expert panel on inflammatory breast cancer: Consensus statement for standardized diagnosis and treatment. Annals of Oncology. 2011;22:15.
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