Breast cancer skin lesions pictures
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Breast Cancer Skin Lesions: Clinical Presentations and Imaging Characteristics
Common Cutaneous Manifestations of Breast Cancer
Breast cancer can present with a variety of skin manifestations, which are crucial for early diagnosis and management. These manifestations include metastatic cutaneous lesions, paraneoplastic dermatoses, and specific syndromes associated with breast malignancy. Common clinical presentations of metastatic cutaneous lesions from breast cancer include erythema gyratum repens, acquired ichthyosis, dermatomyositis, multicentric reticulohistiocytosis, and hypertrichosis lanuginosa acquisita. Additionally, conditions like Mammary Paget's disease and Cowden syndrome, which have specific dermatologic findings, are often associated with an underlying breast cancer.
Types of Skin Lesions in Breast Cancer
Metastatic Cutaneous Lesions
Breast cancer frequently metastasizes to the skin, presenting as various types of lesions such as plaques, pigskin-like areas, scirrhous morphea-like lesions, nodules, zosteriform lesions, and papulovesicles. An unusual form of cutaneous infiltration can appear as red-purple areas with small telangiectasias, without signs of inflammation. Metastatic nodules are the most common presentation, often appearing as erythematous or plaque-like skin thickening.
Inflammatory and Angiosarcoma-like Lesions
Inflammatory metastatic carcinoma, carcinoma en cuirasse, and telangiectatic carcinoma are other clinical variants. These can present as large, indurated, red-purplish plaques with stony hard nodules, mimicking angiosarcoma. Such lesions are often associated with tumor embolization of dermal lymph or blood vessels, leading to impaired lymphatic drainage and blood flow.
Diagnostic Imaging and Criteria
Mammography and Ultrasound
Mammography is essential for localizing calcifications to the dermis or hypodermis, while ultrasound (U.S.) typically offers higher resolution for localizing masses. On U.S., a lesion may be categorized as dermal if it is contained entirely within the dermis, if a tract extends from the lesion to the skin, or if a claw of tissue surrounds the lesion's margin.
Magnetic Resonance Imaging (MRI)
MRI is increasingly used for detecting both benign and malignant superficial lesions. It is particularly useful for identifying superficial, locally extensive, inflammatory, and recurrent breast cancers. However, MRI alone may not always clearly indicate the cause of lesions, necessitating correlation with mammography, ultrasonography, and histologic analysis.
Clinical Case Studies and Dermoscopic Features
Case Series and Clinical Presentations
A retrospective case series highlighted the diverse clinical and radiological presentations of skin metastasis in breast cancer patients. The most common presentation was metastatic nodules, followed by erythematous or plaque-like skin thickening. Imaging studies revealed increased density with indistinct margins on mammograms and diffuse edematous changes on ultrasound and CT scans.
Dermoscopic Patterns
Dermoscopy can be a quick tool to recognize skin metastasis of breast cancer. Common dermoscopic features include yellow central areas, polymorphic vessels, whitish bright lines, and linear irregular fissure-like depressions on a pink-orange background. These patterns are useful for early diagnosis and monitoring of mastectomy scars.
Conclusion
Understanding the varied cutaneous manifestations of breast cancer is crucial for early diagnosis and effective management. Imaging techniques like mammography, ultrasound, and MRI play a significant role in distinguishing benign from malignant lesions. Recognizing specific dermoscopic patterns can further aid in the early detection of skin metastasis, ultimately improving patient outcomes.
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