Inflammatory Breast

Inflammatory Breast Cancer (IBC): Symptoms, Treatment, and Occupational Therapy Strategies

By Amanda Rosso, MS, OTR, CLT, RYT

What Is Inflammatory Breast Cancer?

Inflammatory Breast Cancer (IBC) is a rare but aggressive type of breast cancer that occurs when malignant cells block the lymphatic vessels in the skin of the breast. This results in visible swelling, redness, and warmth—symptoms that are often mistaken for infections such as mastitis. IBC accounts for approximately 4% of all breast cancer diagnoses and requires immediate medical intervention due to its rapid progression.

IBC Symptoms and Warning Signs

Recognizing the symptoms of IBC early can lead to quicker diagnosis and treatment. Unlike most breast cancers, inflammatory breast cancer may not form a distinct lump. Key symptoms include:

• Redness and swelling affecting one-third or more of the breast

• Thickened or dimpled skin, resembling an orange peel (peau d’orange)

• Pain or tenderness in the breast

• Inverted nipple or sudden changes in nipple appearance

• Rapid increase in breast size

• Itching or warmth in the breast

These symptoms often appear quickly over days or weeks. Immediate evaluation by a medical professional is essential.

Risk Factors for Inflammatory Breast Cancer

Although the exact causes of IBC are still being studied, risk factors may include:

• High body mass index (BMI) or obesity

• Family history of breast cancer

• Younger age at diagnosis compared to other types of breast cancer

Women with dense breast tissue or delayed follow-ups after noticing symptoms may also face a higher risk of delayed diagnosis.

How Is Inflammatory Breast Cancer Diagnosed?

Diagnosis typically involves:

• Imaging studies (mammogram, ultrasound, MRI)

• Skin or tissue biopsy

• Axillary lymph node dissection (ALND) to determine cancer spread

ALND involves removing lymph nodes from the underarm (axilla), which can disrupt lymphatic drainage and increase the risk of lymphedema, a chronic swelling condition.

Treatment Options for Inflammatory Breast Cancer

Because of its aggressive nature, IBC treatment often starts with chemotherapy to reduce cancer spread. A multimodal treatment plan typically includes:

• Neoadjuvant chemotherapy (before surgery)

• Mastectomy (surgical removal of breast tissue)

• Radiation therapy

• Targeted or hormonal therapies, depending on cancer subtype

Reconstruction surgery is less commonly performed due to the complexity of treatment and risk factors involved.

Occupational Therapy for Inflammatory Breast Cancer Patients

Occupational therapy (OT) plays a vital role in cancer rehabilitation, supporting recovery from IBC by addressing both physical and emotional challenges. As part of a comprehensive cancer care team, OTs help patients regain independence and prevent long-term complications.

Occupational Therapy Interventions for IBC:

1. Upper Extremity Rehabilitation

• Restore shoulder and arm range of motion

• Prevent frozen shoulder (adhesive capsulitis)

• Improve strength and coordination after surgery or radiation

2. Lymphedema Education and Prevention

• Although manual lymphatic drainage (MLD) is contraindicated during active IBC, education on positioning, skin care, and compression garment use (sleeves, camisoles, bras) can be preventative.

• Monitor for early signs of lymphedema or Axillary Web Syndrome (cording) and intervene with therapeutic exercises and tissue mobilization.

3. Fatigue Management

• Teach energy conservation and pacing strategies

• Promote task simplification and adaptive equipment for daily activities

4. Postural and Core Stability Training

• Address changes in posture due to surgery or radiation

• Use breathwork and core engagement techniques to improve stability and reduce compensatory movements

5. Psychosocial Support and Role Reintegration

• Support emotional well-being and body image concerns

• Assist with return-to-work planning and re-engagement in meaningful activities

  
  

Exercise, Recovery, and Long-Term Health After IBC

Regular physical activity is key to preventing complications like lymphedema. Studies show that 150 minutes of moderate exercise per week can significantly reduce lymphedema risk in breast cancer survivors within six months of treatment.

Occupational therapists can design custom exercise and stretching programs to support safe movement, strength, and endurance throughout recovery. Mild compression garments may also aid in reducing swelling and improving comfort.

Preventive Care and Holistic Rehabilitation

An individualized rehabilitation plan should address:

• Posture correction and spinal alignment

• Scar tissue mobility and soft tissue flexibility

• Self-care independence and functional mobility

• Education on long-term self-monitoring for swelling and fatigue

Final Thoughts: Why Early Diagnosis and OT Matter

Inflammatory Breast Cancer requires fast action and a collaborative care plan. Occupational therapy supports not just physical recovery, but emotional resilience, independence, and quality of life. By integrating OT early into cancer care, patients benefit from improved function, fewer complications, and greater overall wellness.

References

Winicour, Jodi. (n.d.). Breast Cancer Rehabilitation. Klose Training. Retrieved 2022, from www.klosetraining.com