Can I Have Breast Conservation Therapy if I Have Inflammatory Breast Cancer?

— -- Question: Can I have breast conservation therapy if I have inflammatory breast cancer?

Answer: Inflammatory breast cancer is a special type of breast cancer. The cancer cells are not only in the substance of the breast, but they are in the skin of the breast itself. We have tried for some years to do breast preservation in women with inflammatory breast cancer. And my personal experience has been unsatisfactory.

This is largely because the skin of the breast itself is quite sensitive; to make certain types of maneuvers to make sure the skin receives the full treatment involves a fair amount of change in the skin, a fair amount of sunburning of the skin during treatment, and a lot of change in the texture of the breast and the appearance of the breast skin following treatment. It works. We have been able to preserve the breast in women with inflammatory cancer. But the long-term outcome -- the appearance of the breast, its feel, its texture, its mobility -- is, to my mind, quite unsatisfactory.

So we have taken to treating inflammatory breast cancer with chemotherapy -- to shrink it -- and then ask the surgeons to remove the breast. And then we give radiation to the chest wall where the breast was located to make sure all the cancer cells have been killed. I personally don't think it's a good idea -- although it's technically possible -- to be treated with breast preservation in the setting of inflammatory breast cancer.

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