Question

A 59-year-old lady presents with a progressive, painless lump in the breast. What is the cause for the following skin change?

• A. Infiltration of subdermal lymphatics
• B. Infiltration of the lactiferous duct
• C. Involvement of Cooper’s ligament
• D. Spread of the tumor to the anterior chest wall

Answer 1

The Correct Option is A

A 59-year-old lady presents with a progressive, painless lump in the breast. The skin change observed in the image is likely due to "Infiltration of subdermal lymphatics."

Explanation:

• The described skin change is commonly associated with breast cancer and is known as "peau d'orange" (orange peel appearance).
• This appearance occurs when cancer cells infiltrate the subdermal lymphatics, leading to obstruction of lymphatic drainage.
• The obstruction causes localized edema and thickening of the skin, resulting in the characteristic dimpled appearance.

Other options:

• Infiltration of the lactiferous duct: This would typically cause symptoms such as nipple discharge or retraction but not the specific skin change described.
• Involvement of Cooper’s ligament: This involvement usually results in skin dimpling or tethering, but not the diffuse skin changes seen in peau d'orange.
• Spread of the tumor to the anterior chest wall: This would potentially cause fixation of the breast to the chest wall but not the characteristic peau d'orange appearance.