Assessing the diagnosis and treatment of inflammatory breast cancer (IBC) survivors in Michigan

Background:
Inflammatory breast cancer (IBC) is a rare and aggressive type of locally advanced breast cancer with poor outcome. The etiology of IBC is unknown and has no definitive molecular or pathological diagnostic criteria (1,3). The diagnosis is based on clinical findings characterized by breast warmth, redness (erythema), edema (peau d’orange) of the skin of breast, with or without a well-defined mass (2).  The initial presentation of signs and symptoms are rapid, ≤3 months. IBC has a younger age of diagnosis in women, average age of 57 years compared to 61.9 years for all breast cancer combined (1). Black women have a higher incidence of IBC than white women based on the 1988 to 2000 SEER registry (1). IBC is a rare and fatal disease which accounts for 1-5% of all breast cancer cases and has a 5-year survival rate of 30% (1,2).
There is a higher proportion of IBC cases found in North Africa, Middle East and Europe than the United States (2). Since IBC is more common in North Africa, substantial research has been conducted in this region. In Tunisia has about 50% of breast cancer cases are due to IBC compared to 1-2% of cases found in the United States (4). Although US rates are lower than other countries, over the last three decades there has been an increase in IBC cases (1). Nationally, there are about 2,693 cases per year diagnosed with IBC and about 150 cases per year found in Detroit, Michigan (5). Currently, there are about seven different IBC foundations in the US advocating IBC and bringing awareness to the seriousness of the disease. There have been several studies conducted on the delay of diagnosis, reporting and seeking of medical care for breast cancer but to our knowledge there no published studies that address the delay in diagnosis and treatment of IBC patients in the United States. 

Study Aims:
The aim of this study is to:
1. understand the US health care referral process of IBC patients and 
2. determine the factors affecting IBC diagnosis (patient education, physician knowledge, common misdiagnosis, treatments, and access to health care). The goal of this study is to develop education material for physicians and patients to help reduce barriers associated with the delay of diagnosis and treatment of IBC.

References: 
1. Anderson WF, Schairer C, Chen BE, Hance KW, and Levine PH. Epidemiology of Inflammatory Breast Cancer (IBC). Breast Dis 2005-2006; 22:9-23.
2. Giordano SH and Hortobagyi GN. Inflammatory Breast Cancer Clinical progress and the main problems that must be addressed. Breast Cancer Research 2003, 5:284-288.
3. Inflammatory Breast Cancer. American Cancer Society. August 2012. Available from: http://www.cancer.org/cancer/breastcancer/moreinformation/inflammatorybreastcancer/inflammatory-breast-cancer-inflammatory-br-ca-aggressive
4. Inflammatory Breast Cancer. National Cancer Institute at the National Institute of Health. April 2012. Available from: http://www.cancer.gov/cancertopics/factsheet/Sites-Types/IBC
5. Schlichting JA, Soliman AS, Schairer C, Banerjee M, Rozek L, Schottenfeld D, Harford J, and Merajver S. Association of Inflammatory and Noninflammatory Breast Cancer with Socieconomic Characteristics in the Surveillance, Epidemiology, and the End Resuls Database, 2000-2007. Cancer Epidemiology, Biomarkers & Prevention; 21 155-65.

Melissa Leon
Melissa Leon Picture

Profile:
I graduated from the University of Florida in 2010 with a B.S. in Food Science and Human Nutrition and a minor in Packaging Science. After working in the industry as a Food Scientist I decided to pursue a career in Public Health.  I will graduate fall 2014 from the University of Nebraska Medical Center with an M.P.H. in Community Oriented Primary Care.

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