A 55-year-old woman comes to the physician with concerns about swelling and pruritus in her right breast. Physical examination shows erythema and prominent pitting of the hair follicles overlying the upper and lower outer quadrants of the right breast. Hard lymph nodes are palpated in the right axilla. The left breast is normal. There are no nipple changes or discharge. She had right breast mastitis 10 years ago while breastfeeding but has no other history of serious illness. Which of the following is the most likely cause of this patient's skin changes?

Question

A 55-year-old woman comes to the physician with concerns about swelling and pruritus in her right breast. Physical examination shows erythema and prominent pitting of the hair follicles overlying the upper and lower outer quadrants of the right breast. Hard lymph nodes are palpated in the right axilla.  The left breast is normal. There are no nipple changes or discharge. She had right breast mastitis 10 years ago while breastfeeding but has no other history of serious illness. Which of the following is the most likely cause of this patient's skin changes?

Quizplus · Accepted Answer

Eductional Objective: Peau d'orange is an erythematous, itchy breast rash with skin texture changes that resemble an orange peel.  It is the key dermatologic presentation of inflammatory breast cancer and is caused by cancerous cells spreading to the dermal lymphatic spaces and obstructing lymphatic drainage.

A 55-Year-Old Woman Comes to the Physician with Concerns About