How do you know the difference between IBC and IDC

Options
bengallover77
bengallover77 Member Posts: 9
edited August 2020 in IBC (Inflammatory Breast Cancer)

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.

· Share on FacebookShare on Twitter

Comments

  • AliceBastable
    AliceBastable Member Posts: 3,461
    edited August 2020

    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.

    · Share on FacebookShare on Twitter
  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited August 2020

    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.“

    https://www.cancer.gov/types/breast/ibc-fact-sheet


    · Share on FacebookShare on Twitter
  • Beesie
    Beesie Member Posts: 12,240
    edited August 2020

    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.


    · Share on FacebookShare on Twitter
  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited August 2020

    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

    · Share on FacebookShare on Twitter

Categories