inflammatory IDC or is it IBC?

The radiologist who did my biospy DXed me with IBC. My path report said IDC. I sought treatment outside my tiny town and my cancer center reread the biospy slides and DXed me with IBC. Unfortunately, it is not possible to make a path report purely objective -- any two people can look at the same thing and see it differently. As always, Bon, our veritable fount of knowledge, is right in saying that when things aren't perfectly clear, you have to treat the more aggressive cancer. I am being treated under the IBC protocol.

There is a theory that IBC is a subset of IDC. But it's only a theory. Having IBC is a hard journey but you can do it. This group is an amazing resource, please ask anything, rant, cry, laugh or whatever you need. I've found that my BCO sisters can help me through anything.

Best wishes,

bride

Here's a document that describes recent revisions in the AJCC Staging System for Breast Cancer:

http://labmed.ucsf.edu/uploads/210/101_new_ajcc_staging_of_breast_cancer_what_has_changed.pdf

This document states that IBC is clinically diagnosed, not a pathology finding. (See p. 4, "Definition of Inflammatory Carcinoma and pT.") Unlike invasive ductal carcinoma or invasive lobular carcinoma, there is no specific cellular cancer type that can be identified under a microscope as inflammatory breast cancer. It's the behavior of the cancer that makes it IBC, and it's naughty stuff.

The characteristics of IBC--warmth, redness and thickness of the skin of the breast--are a result of the skin's lymphatic channels being plugged with tumor emboli. Thus, when my small spot of IDC developed a small, red, peau d'orange "umbrella" of dermal lymphatic invasion, there was controversy between my MO, SO, and RO as to whether a diagnosis of IBC could be applied.

It really didn't matter, though, as far as treatment went. As Bride says, they treated it as if it were IBC and threw the kitchen sink at it.

I was diagnosed clinically with IBC after the FNA biopsy that determined IDC. The symptoms were classic as I have posted elsewhere on BCO. Because they started chemo urgently, there was no chance to do any skin tests, but by the second treatment the IBC was visibly reversed. By the sixth treatment the breast was normal and all that remained was the small IDC lump which was removed along with all the lymphs in the mastectomy. Radiation followed.

The point to be made is that with attentive treatment you'll be on the road to recovery soon.

Dancingdiva, your first question--"Is IBC only in the skin but underlying their is something else IDC,ILc, etc?" is a good question! I'm not completely sure, but I think it can be either way. Sometimes there's a lump, with dermal lymphatic invasion that appears to be associated with the lump, and sometimes the cancer can only be found in the dermal lymphatics of the skin. And sometimes there's a lump that's diagnosed with a biopsy, with clear signs of IBC, and no skin biopsy comes up positive. In these cases, it's still treated as IBC.

Navelbine and Xeloda are chemotherapy drugs. I had researched the latest studies and convinced my MO that since my MX pathology report stated there were tumor cells still present in the skin of the breast, we should go for more chemo. The TAC chemo I had received prior to my MX had not completely wiped out the cancer, which is not unusual with ER+. I wanted to be sure we attacked any cells that might be lurking around after my chemo. Navelbine and Xeloda aren't typically thought of as standard treatments.

I don't believe there is a specific protocol for IBC--it's up to your MO--but whatever regimen they choose for IBC, it's the "big guns." And that's what your ACT was, a big gun.

I get 4xFEC and 4xtaxotere. This is the standard treatment for IBC in France, if your not stage IV at diagnosis and like me ER+ and HER-.

Noor

Dancing Diva,

I had both. I think the idc tumor made it easier to detect the problem since I actually had a tumor with inflammatory presentation.

Terri

My MO (my third one) explained to me that there are two archetypes of BC: that which is within the duct and that which has grown outside the duct. In that sense, IBC is a type of IDC. However, unlike IDC, IBC involves more skin tissue and is possibly triggered in a different way than IBC. She said that if you present with clinical indications of IBC, you have it even though the cellular structure doesn't differ from IDC to IBC.

Sorry ths is incoherent. I'm freaking out because they found something on my spine. I'm waiting for a biospy. And feeling much, much, much more scared than I was when I was first DXed.

bride