Rare breast cancer can look like bug bite

It all started with what looked like a bug bite.

After working in the garden, Nancy Key of Camano Island noticed a spider bite on her side and an itchy spot on her right breast.

Key, who was 47 at the time, didn’t think much about it until a few weeks later when the breast skin began thickening and forming ridges like an orange peel and the whole area started to swell.

She called her doctor right away and that’s probably what saved her life.

A biopsy revealed inflammatory breast cancer, a rare and deadly type that commonly strikes younger women. Yet most women aren’t even aware of it.

“I was pretty mad I was going to die from something I’d never heard of,” Key said.

Key had done all the right things. She’d seen her doctor annually and examined herself every month. There were no lumps or signs of breast cancer as pictured on her self-exam reminder card. A screening mammogram a few months earlier had showed nothing unusual. But there it was: She had breast cancer – the worst possible kind that rarely gets talked about.

While undergoing chemotherapy, radiation and surgery, Key searched for information about IBC. She learned, for example, that the cancer makes up less than 6 percent of the more than 200,000 new cases of breast cancer that occur in the U.S. each year.

It’s the most aggressive form, however, spreading quickly to other parts of the body. By the time women are diagnosed, most already have lymph node involvement. That’s why a speedy diagnosis is crucial to recovery from IBC.

All too often, though, patients and doctors ignore the warning signs, thinking it’s a bug bite or breast infection. The symptoms are so different from the expected signs of breast cancer. And, usually, there is no lump.

Instead, the cancer grows as sheets that spread throughout the breast.

When cancer cells block lymph vessels in the breast skin, each person can react somewhat differently. Symptoms may include:

* Redness, warmth, swelling or enlargement of a breast, often occurring suddenly;

* Itching or pain in the breast that won’t go away;

* Thickening, pitting, dimpling, bruising or a rash of the breast skin;

* Nipple retraction, flattening or discharge;

* A color change in the areola (the dark skin around the nipple);

* Swollen lymph nodes in the neck or armpit.

Key knows a 16-year-old girl who just died from IBC.

The Susan G. Komen Breast Cancer Foundation says that IBC occurs more often in younger women than other forms of breast cancer, sometimes even afflicting women who are pregnant or breastfeeding.

The cancer usually is not hereditary and the cause is unknown, though hormonal factors may play a part.

No matter what your age, it’s crucial to insist on a thorough evaluation if you notice a change in your breasts.

“We as women know our bodies better than anybody,” Key said. “And we have to be our own advocates. Don’t let a doctor tell you, ‘Oh, let’s just wait and see.’ “

Do whatever it takes, even if that means getting a second or third opinion, she suggests.

With today’s improved treatments, recent studies have shown that as many as 50 percent of women with IBC are alive five years after diagnosis. Key is among them.

This condition is “treatable and survivable,” she says, and the faster it’s discovered the better.

Contact Dr. Elizabeth Smoots, a board-certified family physician and fellow of the American Academy of Family Physicians, at doctor@practical prevention.com. Her columns are not intended as a substitute for medical advice or treatment. Before adhering to any recommendations in this column consult your health care provider.

2006 Elizabeth S. Smoots.