“IBC differs greatly from other forms of breast cancer in a number of ways, so it requires a dedicated approach that focuses on a unique set of challenges,” said Thomas Buchholz, M.D., medical director of Scripps MD Anderson and a lead physician in its IBC clinic. “It’s often hard to diagnose and it can spread fast, so it’s critical that patients receive prompt treatment from experienced specialists working together as an integrated team.”
Dr. Buchholz co-founded the world’s first IBC clinic, the Morgan Welch Inflammatory Breast Cancer Clinic at The University of Texas MD Anderson Cancer Center in Houston in 2006, and he is among the most experienced radiation oncologists in treating and researching the disease. Joining Dr. Buchholz as lead physicians with the Scripps MD Anderson IBC clinic are surgeon Ayemoethu Ma, M.D. All three also are Scripps Clinic doctors. Additional physicians are expected to join the IBC clinic.
Signs and symptoms
Unlike more common forms of breast cancer, IBC typically is not detected during an exam and often goes undetected by a mammogram or ultrasound. With IBC, cancer cells grow in sheets that spread through the breast. IBC symptoms vary from person to person and may include breast swelling and tenderness, with skin that is reddened and thickened, sometimes dimpled in texture like an orange peel. Other symptoms can include itching, warmth, pain and flattened or inverted nipples.
Patients with these symptoms are frequently thought to have infections and are treated with a course of antibiotics. For this reason, women with IBC often have a delayed diagnosis of their disease.
The symptoms, which can include breast swelling, are caused by cancer cells blocking lymph vessels in the skin and soft tissue of the breast. This results in a buildup of lymph, a clear fluid containing tissue waste and cells that help fight infection.
An inside look
According to the National Cancer Institute, IBC accounts for 1 to 5 percent of all breast cancers. It progresses so rapidly – often in a matter of weeks or months – that it is almost always diagnosed either at stage 3 or 4, depending on how far the cancer cells have spread. Due in part to the delayed diagnosis, survival rates for IBC patients are generally lower compared to other breast cancers.
IBC also tends to be diagnosed at younger ages, compared to other forms of breast cancer. It appears to be more common in African-American women than women of other races and ethnicities. IBC tumors are frequently hormone receptor negative, a biologically more aggressive subtype that does not respond favorably to hormone therapies.
Multidisciplinary team approach
At Scripps MD Anderson’s IBC clinic, experts in medical oncology, radiation oncology, surgery, pathology and radiology form a multidisciplinary team. Working together, they are able to provide the patient with a diagnosis and personalized treatment plan.
According to Dr. Buchholz, it is essential to establish a comprehensive and personalized treatment plan for IBC as early as possible. “IBC has unique biologic behaviors and patterns of spread, so our plan of attack requires very specific treatment algorithms, which have been shown to achieve successful outcomes,” he said.
Doctors involved in the Scripps MD Anderson IBC clinic have specialized training and clinical experience in diagnosing and treating IBC. They also interact regularly with their counterparts at the IBC clinic at MD Anderson Cancer Center in Houston, adding a deeper level of expertise to each patient’s care.
Another important aspect of the new Scripps MD Anderson IBC clinic is its integration and collaboration with MD Anderson’s Morgan Welch IBC clinic in Houston. The Scripps IBC physician team will have the opportunity to review cases under their care with colleagues in Houston.
First patient a study in perseverance
Auburn, Calif., resident Andrea Dean-Zander, the first patient to be treated at Scripps MD Anderson’s IBC clinic, completed her treatment plan in early April. She has enjoyed being active throughout her life, including hiking, skiing and spin classes.
Last year, Dean-Zander noticed her right breast had become swollen, red and hot, and later, itchy. The 44-year-old real estate agent visited her primary care physician’s office, where she was prescribed a 10-day course of antibiotics for what was thought to be an infection. But when there was little improvement, she researched her symptoms and for the first time learned about inflammatory breast cancer.
Knowing how quickly IBC can spread – and dissatisfied by how long she had to wait to schedule a series of imaging tests – Dean-Zander decided to visit MD Anderson in Houston. There, she was seen by a multidisciplinary team of physicians who expedited her treatment plan and medical care. Within days of her arrival, she began chemotherapy, followed by mastectomy surgery.
During her time in Houston, Dean-Zander learned Dr. Buchholz had moved to San Diego to lead Scripps MD Anderson Cancer Center, and decided to finish her radiation therapy, the final part of her treatment, in San Diego. In February, she moved Pacific Beach, where she plans to stay until her treatments conclude.
“We all hear about breast cancer, but IBC isn’t regular breast cancer,” she said. “It’s aggressive and you have to stay on top of it, with a team of doctors who really understand the unique ways it needs to be treated. It’s a huge step forward for people on the West Coast now that Scripps MD Anderson has its IBC clinic available.”
The clinic is open to both newly diagnosed and previously treated patients and is also available for second opinions. More information on the IBC clinic is available by calling 1-800-SCRIPPS or by visiting scripps.org/cancer.
A powerful partnership
Scripps Health and MD Anderson have teamed up to create the Scripps MD Anderson Cancer Center, a clinically integrated cancer care program in San Diego that began delivering care in 2018. The partnership brings together the expertise of doctors at Scripps and MD Anderson to offer patient-centered care, using some of the most advanced cancer treatments available today.
Through this partnership, Scripps MD Anderson is part of MD Anderson Cancer Network®, a global collaborative network of hospitals and health care systems dedicated to MD Anderson’s mission to end cancer. The collaboration allows Scripps to combine its expertise with MD Anderson’s knowledge and capabilities to further elevate the level of care for patients in San Diego.
ABOUT SCRIPPS HEALTH
Founded in 1924 by philanthropist Ellen Browning Scripps, Scripps Health is a nonprofit integrated health care delivery system based in San Diego, Calif. Scripps treats more than 750,000 patients annually through the dedication of 3,000 affiliated physicians and more than 15,000 employees among its five acute-care hospital campuses, home health care services, 27 outpatient centers and clinics, and hundreds of affiliated physician offices throughout the region.
Recognized as a leader in disease and injury prevention, diagnosis and treatment, Scripps is also at the forefront of clinical research. With three highly respected graduate medical education programs, Scripps is a longstanding member of the Association of American Medical Colleges. Scripps has been ranked five times as one of the nation’s best health care systems by Truven Health Analytics. Its hospitals are ranked No. 1 in San Diego County and among the best in the nation by U.S. News & World Report. Scripps also is recognized by Advisory Board, Fortune and Working Mother magazine as one of the best places in the nation to work. More information can be found at www.scripps.org