Which is best way to diagnose ibc

Pisces916

For the past month I have had a red patch that has not gone away with antibiotics. I am 47 and have read that it is unlikely cellulitis if you are not lactating. Just a couple of weeks ago my lymph nodes under my arms have become swollen. I have heard that skin punch biopsies can have false negatives. Is requesting a breast MRI the best way to determine if someone has ibc? Do MRI's also have false negatives? If you do receive a punch biopsies is it safe to biopsy the lymph node under the arm without damaging the lymph node? Truly appreciate all advice that can be given!

djmammo

Pisces916

Has this patch worsened/enlarged/spread daily since you first noticed it? Is the skin of that breast becoming thickened and hard? Is the breast contracting and is becoming less movable?

If IBC is suspected clinically, punch biopsies of the area of skin thickening is the way a diagnosis of IBC is confirmed. The swelling and thickening of the skin is due to obstruction of the lymphatics within the skin of the breast by cancer cells. The biopsy goes through those lymphatics and the cancer cells are sought with a microscope.

In the right hands an ultrasound guided lymph node biopsy is a fairly simple and safe procedure. There is no damage to the lymph node that would cause any problems that I have ever seen personally.

All tests can have false negatives.

Pisces916

Hi djmammo. Thank you for your reply and questions. Pardon my delay haven't been feeling well.

The patch has stayed the same. The skin on breast has not thickened or hardened. The skin on my nipple does look thicker though. The breast has not contracted or became less movable. It has been a month. Was wondering how long it would take for these symptoms to happen if it was ibc? I was denied a biopsy so requested a MRI which was approved. Does ibc look the same as other cancers on a MRI? If not how does ibc appear on a MRI? Can a radiologist that is unfamiliar with ibc be able to identify the cancer if is ibc? Greatly appreciate your advice!

djmammo

Pisces916

The skin thickening is pretty obvious on an MRI if present. If there is a cancer presenting as an enhancing mass on an MRI it won't matter what kind of cancer the radiologist thinks it is, the purpose of the MRI at this point is to indicate where to perform the biopsy for a definitive diagnosis. Most breast mri's are read by breast radiologists but not all.

In a month's time IBC would have declared itself clinically as it is rapidly progressive.

Here is the conclusion of an article on this subject. The complete article can be found can be found HERE:

"Multiple small, confluent, heterogeneously enhancing masses and global skin thickening are key MRI features of IBC that contribute to improved detection of a primary breast cancer and delineation of disease extent compared with mammography"

Pisces916

Thank you so much for your response! So far there has been no skin thickening and the red spot has faded to a light pink. I am relieved to hear that since it has been a month and it hasn't gotten any worse that it is unlikely ibc. I think my biggest concern were my swollen lymph nodes but they are not hard and are movable which is a good sign that it is not cancer and is most likely an infection. I will be getting a breast MRI this Tuesday and hopefully ibc will be ruled out. Thanks again for your help I truly appreciate it!