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Topic: How do you know the difference between IBC and IDC

Forum: IBC (Inflammatory Breast Cancer) —

Just diagnosed, in treatment, or finished treatment for IBC. Posting pictures of symptoms is prohibited per our Community Rules -- you are encouraged to seek medical advice from your doctor in the event of any concerns.

Posted on: Aug 12, 2020 12:39PM

bengallover77 wrote:

My mom is 74, she hid a large ulcerative fungating mass on her breast from us because she thought it was shingles. Her hematologist said when he first saw it that it was IBC and sent us immediately for a punch biopsy which was performed within 30 minutes of him seeing it. The surgeon also said IBC. We also had a PET scan that unfortunately revealed bones mets on one rib, T2 and L4 and micronodules in her lung that are suspicious for metastatic disease. We have the preliminary pathology back that simply says adenocarcinoma consistent with breast carcinoma. We do not know if it is HR positive or not yet, we find that out next week. We also saw a radiation oncologist today for a consult to discuss palliative radiation for the fungating mass, he said he did not think it was IBC and said it was IDC. My mom cannot travel and does not want to travel far for a second opinion but we have talked her into going to a different cancer center that works with the Mayo Clinic for a second opinion. Is there something I should be looking for on the pathology report that would indicate if this is IBC or IDC? Her hematologist who is also an oncologist said that he felt it was because of the skin involvement, but the radiation oncologist (they work in the same group) said he didn't think it was. I just need to know how the proper diagnosis is made.

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Aug 12, 2020 03:47PM AliceBastable wrote:

The punch biopsy results should be definitive. It sounds like the confusion stems from the cancer having advanced enough to break through the breast skin, but if I understand it correctly, IBC starts in the skin and advances very rapidly. How old is your mother? And until the lung nodules are checked, they could be just cumulative crud. I have several, as do most people once they get to a certain age.

Endometrial cancer 2010, basal cell multiples, breast cancer 2018, kidney cancer 2018. Boring. Dx 5/2018, ILC/IDC, Left, 2cm, Stage IA, Grade 2, 1/1 nodes, ER+/PR+, HER2- Surgery 7/11/2018 Lumpectomy: Left; Lymph node removal: Sentinel Surgery 8/8/2018 Radiation Therapy 10/29/2018 Whole-breast: Breast, Lymph nodes
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Aug 12, 2020 06:08PM MelissaDallas wrote:

It can be both. IBC usually is IDC.

“Inflammatory breast cancer is rare, accounting for 1 to 5 percent of all breast cancers diagnosed in the United States. Most inflammatory breast cancers are invasive ductal carcinomas, which means they developed from cells that line the milk ducts of the breast and then spread beyond the ducts.“

LCIS, extensive sclerosing adenosis, TAH/BSO & partial omentectomy for mucinous borderline ovarian tumor.
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Aug 12, 2020 06:40PM Beesie wrote:

I don't know, but would it matter at this point? Unfortunately it appears that your mother may be Stage IV and I would assume her ER and HER2 status will determine the treatment plan.

“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Aug 13, 2020 11:00AM sbelizabeth wrote:

Inflammatory breast cancer isn't a specific "type" that a pathologist would label in a report. It's a clinical diagnosis, meaning it's diagnosed by a biopsy that declares it to be cancer, it's found in the dermal lymphatics of the breast skin (usually with a skin punch biopsy), and it has some of the clinical features of redness, peau d'orange, swelling, heat.

If you were to put isolated cancer cells under a pathologist's microscope, he/she could determine if the cells were either ductal or lobular (the two main types of breast cancer) but without the information that the cells were located in the lymph channels of the skin, the pathologist couldn't say "inflammatory breast cancer."

A malignant tumor that's left untreated for many months or years can grow upwards and into the skin. It can then break through the skin and cause an open sore (or ulcer) on the skin surface--a "fungating" wound.

I agree with Beesie and the others here; at this juncture it doesn't really matter. The goal for your mom would be to treat the wound and her other mets by beating back the cancer. Fungating wounds aren't seen a lot in the US, although they're very common in developing countries. If your mom is up to it, I think a second opinion would be a good idea. Blessings, gentle hugs, and good luck--SB

pinkribbonandwheels.wordpress.... Dx 10/20/2011, IDC/IBC, Left, 1cm, Stage IIIA, Grade 2, 6/28 nodes, ER+/PR+, HER2- Chemotherapy 12/15/2011 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/18/2012 Mastectomy: Left Radiation Therapy 5/21/2012 Breast, Lymph nodes Hormonal Therapy 7/19/2012 Femara (letrozole) Surgery 4/15/2013 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap

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