A multi-disciplinary approach is necessary to successfully treat inflammatory breast cancer. A typical treatment plan will include chemotherapy initially, surgery, radiation therapy and possibly endocrine therapy to prevent recurrence.
The goal of chemotherapy is to eliminate or reduce inflammatory breast cancer before surgery. Using chemotherapy before surgery is call neoadjuvant chemotherapy. Anthracyclines (doxorubicin or epirubicin) and taxanes (paclitaxel or docetaxel) are the most effective chemotherapy drugs for IBC. Most women with IBC receive a combination of at least two different drugs.
Chemotherapy should be started as soon as possible to prevent the spread of the disease. If the disease has not metastasized (spread beyond the breast), chemotherapy treatment will last about six months, and involve several different chemotherapy drugs. These are very active drugs in the fight against breast cancer and generally you will see a marked improvement once chemotherapy starts.
Because inflammatory breast cancer does not present as a distinctive lump, surgery to remove just the cancerous tissue (lumpectomy) is usually not possible. A complete mastectomy (removal of the entire breast) is recommended to get all of the affected areas. Many women with inflammatory breast cancer have axillary lymph nodes involved. The surgeon will be evaluating lymph nodes at the time of surgery. Breast reconstruction is not recommended until therapy has been completed and there is no evidence of disease.
After chemotherapy and surgery is completed, radiation therapy is performed on the chest wall and lymph nodes. Radiation helps control disease and reduce the risk of recurrence, and may also be used to treat metastatic disease and manage pain, or for patients who cannot undergo surgery. Women with inflammatory breast cancer typically have twice-a-day radiation.
If the inflammatory breast cancer tumor is hormone receptor positive (Estrogen Receptor [ER] or Progesterone Receptor [PR]), then hormone therapy will be required. Oral medications designed to either block the production of estrogen and progesterone, or stop their activation. The type of hormone therapy depends on the patient's menopause status, but all patients can expect to remain on hormone therapy for five years.
Stem Cell Transplant
For a certain population, patients after completing their initial therapy or have responding metastatic disease, a stem cell transplant may be option with the goal to reduce the chance of recurrence.