What happened, in summary

Nikki first noticed sharp pain around her right nipple in August 2022. Because there was no lump and she had been told that cancer usually did not hurt, she attributed it to menopause. By late November, her nipple had become completely inverted. A biopsy and contrast imaging confirmed inflammatory breast cancer, a form that can spread through the breast without creating a single lump.

The cancer was grade 2, hormone-positive and HER2-positive, with regional lymph-node involvement but no distant spread on repeated PET scans. This was Nikki’s second cancer; years earlier, surgery had removed a separate neuroendocrine tumor from her small bowel.

Because inflammatory breast cancer can progress quickly, treatment began with chemotherapy to shrink the diffuse disease before surgery. Nikki completed 3 rounds of EC followed by 4 rounds of docetaxel, for 7 rounds in total. Treatment caused hair loss, severe fatigue, hand-foot symptoms, bone pain, mouth problems and early menopause. Imaging showed an excellent response with no visible disease, although her team explained that microscopic cancer could remain.

At the time of the interview, Nikki was preparing for a single mastectomy on June 9. Radiation every day for about 3 weeks and years of hormone therapy were planned afterward. She used her experience to emphasize that inflammatory breast cancer may cause pain, swelling, skin changes or nipple inversion even when no lump is present.