Many people have been surprised to hear that the treatment for my breast cancer began with chemotherapy. In fact, less than three weeks after diagnosis, I had my first round of chemo. It would have been a week earlier, even, except that the results of all the tests and scans were delayed due to the July 4th holiday.
Inflammatory breast cancer is different from other forms of breast cancer. Scientists don’t even know if it’s actually that closely related to traditional breast cancer, or if it just happens to occur in the same part of the body. There just aren’t that many cases to study, and there hasn’t been much interest in studying this rare disease until recently.
Traditional treatment for any breast cancer begins with a lumpectomy or masectomy, especially if the cancer has not metastisized, or spread beyond the breast and lymph node system. The difficult thing about IBC is that by the time it is diagnosed, it has already spread to the skin, or, more accurately, to the lymphatic system, which means it can spread more easily than a lumpy cancer. A masectomy is a surgical procedure, removing skin as well as breast tissue, and, well, just about everything related to the breast, depending on the type of masectomy that is performed. As such, it makes the area more vulnerable to infection AND a fertile ground for the spread of the cancer cells. Masectomy also increases the chance of recurrence because the skin is stitched together after a masectomy.
Chemotherapy is now the first line of treatment for IBC because it reduces the size of the tumor, making surgery more possible without this huge chance of spread right away. It also kills the cancer cells that have spread throughout the body — which is a huge possibility with cancers that are 2 inches or more — or IBC, which covers large portions of the skin. The larger the cancer, the more chance that individual cells have spread throughout the body and begun to grow. But we can’t see these small cells with today’s scans, so we have to start with a systematic treatment
But the most important thing to know is that chemotherapy before masectomy increases the chance of survival. A decade ago, only 2% of IBC patients survived 5 years. Today, with chemotherapy the preferred first treatment, 40% of IBC patients survive 5 years.
That’s reason enough for me to do chemotherapy first.