punch skin biopsy

A skin punch can detect IBC IF it is there in the area checked.  My IBC was DXd via FN biopsies of an enlarged node under arm and some areas in breast.  My skin did not show any abnormalities thus nothing for a skin punch to check. 

You will have to ask them what comes next (if anything at this time).  I am not a medical professional at all but I would doubt that FNBs of discolored skin would be done after a negative skin punch.  There are so MANY possibilities for skin discoloration along with pain and swelling.  Based on what I've read/been told, IF IBC is present, it will show up in the biopsy of an area showing what might be 'signs' as the lymphatic system is involved.

I found an enlarged lymph node under arm one night that had not been there the night before.  It was about the sze of an almond.  My PA was on vacation and as I only wanted to see her, it took me a week to get in.  In that week the node greatly enlarged.  I saw her at 11 and she had me at Radiology Clinic at 1 for a new mammo which turned into also a sono and biopsies.  I left there about 3 and had the path. report at 8 the next morning - as expected IBC.  In the next 17 days til I started neoadjuvant chemo, my breast increased, peau d'orange developed and nipple inverted.  I never had any pain/discomfort/itchiness or discoloration.  We are each so different so there is no exact as to how our body reacts to anything.  What my body did is not the same as all do, just as my experiences are not exactly what anyone else has experienced.

Tmess,

There are no hard and fast rules with IBC. I didn't have enough skin involvement to warrant a skin punch though my nipple was inverted, etc.. Mammo and sono showed 3 masses in breast. Yupe, it was IBC with lymph node involvement: at first, needle biopsy showed only 1 axillary node as involved, later, MRI, added 2 more 'shadowy' nodes. Number of nodes seemingly doesn't matter with IBC: anything but axillary lymph node dissection is counter-indicated, though I've been told that the decision as to do an ALND as opposed to sentinel dissection will be a OR decision. I said nope, if I'm going to agree to anything less than what is recommended, I want a damn good reason why.

The point in this meandering post is that Kicks has hit the nail squarely on the head with her remark that we are all so unique. Or, to put it another way, IBC's typical presentation is never typical. And that's why a quick response biopsy is so important. Personally, I'd want more than a skin punch, if only to be clear on what was going on.  And I'd refuse to wait on bloodwork: IBC is very invasive and aggressive. IMO, it should be aggressively DXed. Within 3 weeks of my DX, I was getting my first chemo. But that's just my opinion: we really are all so unique (thanks for saying it so well Kicks.)

bride

I pray that this is not IBC. But if it is, we're all with you.

Tmess,

Without a target, it is impossible to do a meaningful biopsy. If your docs have no positive indication that it isn't IBC, I would hope they would do a lymph node work up. Of course, since my IBC presented with no pain or signs of node involvement, I was pretty freaked out that there was such involvement.

Still hoping you don't have IBC,

bride

Tmess,

Why are you dealing with a surgeon rather than an oc who specializes in imagery such as mammos and us? If I was as certain as you are that it is IBC and was getting no useful info from my radiologist, I'd find a medical oncologist. IBC is so rare and weird that, personally, I'd want more than a surgeon's DX. But I also had palpable masses in my lymph node and breast so getting a DX was fairly straight forward. Like many of us, I had never heard of IBC -- given that out of 250K new breast cancers reported yearly just in the USA, only 12,000 are IBC and I had no particular reason to suspect I had it. I absolutely understand your fears and hope you can get a solid DX soon.   Keep us posted.

 bride

skin thickening?   That is something that should be checked out.  Are you seeing breast specialists?

I would definitely see a "breast" specialist..

I had a red breast and skin thickening on MRI.  My doctors found a 3.6 cm IDC tumor in my breast, but I also had cancer in the skin lymphatic system.  

There is really no way to know.  You just need to get it all checked by a specialist.  I have also had 3 scares on the opposite breast that all turned out benign and were suspicious on MRI.  So, you just don't know, but don't let it go.  I persisted with the red breast when some doctors easily sent me on my way.  

Tmess,

You have an appt. with an oncologist in a few days, yes? I'd see what she says before I'd accept a rescan in a month. IMHO, everyone needs a medical oc and I'm relieved you're seeing one. 

sending best wishes,

bride