Sunday, July 15, 2012

Inflammatory Breast Carcinoma with Local Recurrence

One of our great latter day scourges is breast cancer.  In spite of advances in treatment, as well as advances in detection, we still have a relative epidemic of breast cancer, and it still regularly kills women and men.  The picture above is one of tragedy and pain.  This poor woman had a mastectomy some years earlier, and, plague by bouts of depression, ignored the rash that arose around her post-mastectomy scar.  Only after being essentially forced to seek treatment did she get evaluated.  As you can see, the cancer had extended in a pagetoid fashion through the dermis to the surrounding skin and onto the contralateral breast, with an irregular border and with nodules in the field as well.

For those who said radiation dermatitis, please keep in mind that radiation derm is very well demarcated and usually rectangular in shape, with clearly delineated linear borders.  For those that guessed other answers, admittedly this is a tough pic to figure out, but the scar is pretty obvious with the inflammatory carcinoma extending from it.  

There ar multiple historic names attached to this kind of breast cancer, but the most common ones are carcinome en cuirasse (cancer that is like a breast plate) or carcinoma erysipeloides (because it looks like erysipelas.  

This was nice work on your parts to parse out this difficult pic and put the puzzle together.

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