DR. HOOK- Breast cancer: Inflammatory strain particularly deadly

Tara is what Scarlett O'Hara fought for. But is land so important to fight for that you reduce yourself to wearing drapery and marrying a man you don't love? 

Someone once told me, "The secret to being a lady is knowing when to be a woman." So Scarlett got Tara back, but her daughter died, and Rhett walked out on her (while using profanity back in the day). But "tomorrow is another day." (Say, "Cheese!")

I was emailed by a reader, Tara G., to a talk about Inflammatory Breast Cancer (IBC). (How does a Yankee get a name like Tara? It's like me being named "Beauregard.") Tara and I actually used to work together, and let me tell you something: She could sell a bridge in Madison County as well as in Brooklyn to Meryl Streep and Clint Eastwood. She's so influential, and her positive energy makes you feel like the plague never existed. ("Rats? What rats?")

Tara is also the daughter of a pretty well-known Republican politician. Yet to prove how "purple" Virginia has become, some of the things she has done and the things she believes in make her more liberal than I am. Mmmhmm. Once I swore she was a Democrat, and she passionately responded, "That's the meanest thing anyone has ever said to me." 

Tara loves people and fights for everyone, in particular those in need. So true to that reputation, she wants me to talk about IBC because many women have never heard about it. 

IBC is seen mostly in women who live in medically under-served areas, and it's one component of Locally Advanced Breast Cancer. Breast cancer is the #1 cancer and #2 cancer killer in American women. IBC is a very aggressive, fast-growing breast tumor that easily metastasizes— meaning spreads to other parts of the body. In fact, about 100 percent of women with IBC have lymph node involvement, making IBC a Stage IIIB cancer (not good). 

Primary IBC represents only 0.5-2.0 percent of all invasive breast cancers, but for some reason it's on the rise. African American women are affected by IBC more than white women. 

IBC causes inflammation of the breast's skin and invades the lymphatic system (part of the immune system). So it's painful, warm, tender, and spreads quickly to enlarge the breast (and not in the way you want). Peau d'orange is a medical term to describe how it looks because the texture/appearance is like the skin of an orange. But the color is pink to red to purple. Sometimes a breast infection such as mastitis or an abscess can mimic the look of IBC.

I've seen women with peau d'orange, and it just makes your heart sink because usually they have waited a long time before seeking help– due to denial or a lack of resources. 

IBC is diagnosed by appearance, mammography, and a core needle biopsy. CT scans of the chest, abdomen, and pelvis are done to stage the extent of the breast cancer. Bone scans are done to see if bones have been invaded by the cancer. 

Treatment involves a hodgepodge of surgery, chemotherapy, radiation therapy, and adjuvant therapy. But only about half of women diagnosed with IBC live as much as 2.5 years.

We need a Tara, the ultimate believer and ultimate optimist, to get all women motivated to do self-examinations of the breasts, yearly check-ups, and routine mammograms. Also we need a Tara to stir things up enough to find a cure to prevent 1 in 9 women from getting breast cancer. Anything less would be tarable.

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.