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Tests and diagnosis
By Mayo Clinic staffA diagnosis of inflammatory breast cancer is based on your medical history, your physical examination and an excisional biopsy — taking a small sample of skin and some of the underlying tissue to examine under a microscope. An excisional biopsy that includes the skin is helpful because a hallmark of inflammatory breast cancer is finding tightly packed clumps of cancer cells (tumor emboli) in the lymphatic vessels of the skin. Imaging tests — mammogram and breast ultrasound — also may be used to confirm the diagnosis by showing areas of skin thickening.
If the biopsy results confirm that you have inflammatory breast cancer, the next step is to determine how advanced your cancer is — its stage, or extent and severity. Your doctor may perform additional tests, such as a CT scan of your chest and abdomen, chest X-ray, and bone scan, to check for the presence of cancer cells in other parts of your body (metastases).
Your cancer will also be tested for the presence or absence of receptors for the hormones estrogen and progesterone, and to see if the cancer produces too much of a protein called HER2. Inflammatory breast cancers are often hormone receptor negative and HER2-positive.
Inflammatory breast cancer is classified as stage IIIB or stage IV breast cancer. Stage IIIB is locally advanced cancer — meaning it has spread to nearby lymph nodes and to the fibrous connective tissue inside the breast. Stage IV cancer has spread to other parts of your body, such as bones or liver. About one-third of newly diagnosed inflammatory breast cancers are stage IV.
