Suspicious red spots may be sign of deadly disease

• Warning signs for inflammatory breast cancer

By Beverly Creamer
Advertiser Staff Writer

While women have been conditioned to check their breasts for suspicious lumps every month, have regular mammograms if they're over 35, and get annual check-ups from their physician, few know that they should also be on the watch for suspicious red spots or patches on their breasts.

Such symptoms may be a sign of a rare but deadly form of breast cancer called inflammatory breast cancer.

"It looks like an infection and usually the whole breast or part of the breast is bright red, and it doesn't go away," said Dr. Laura Hoque, medical director of the Kapi'olani Women's Center and a breast cancer surgeon.

Hoque said this cancer occurs in 1 percent to 5 percent of breast cancer patients, but is one of the most dangerous forms of the disease. It's also commonly misdiagnosed and may be treated first with antibiotics.

She warns that if a red patch on the breast does not respond to antibiotics, the patient should immediately see a surgeon for a mammogram, examination and biopsy, vital for diagnosis.

"Patients get chemo immediately, and then radiation," Hoque said. "It's considered to be a sign of cancer throughout the body."

A mastectomy must be done, she said. Lumpectomy is not an option.

A second rare breast cancer affects the nipple, causing a crusting on the surface. But with this one, called Paget's disease, patients have an excellent survival rate, although it, too, requires mastectomy.

While only a handful of her patients have either of these rare forms of the disease, Hoque said women should be alert to the signs of either. Physicians are not always familiar with these two, and diagnosis may be missed in early stages.

"It's important to raise women's awareness of it," she said.

Warning signs for inflammatory breast cancer

• Change in breast texture. Skin may appear dimpled, like an orange.
• Increase in breast size over a short period of time
• Breast area becomes red and may be warm or hot, with some itching or pain.
• A lump may or may not be present.
• Swollen lymph nodes under the arm or above collarbone
• Discharge from the nipple and changes in the nipple shape, making it flattened or inverted