Behind the Bra: Malignancies of the Breast

Conclusions

• Breast cancer is the second most common malignancy in women and the primary cancer that frequently metastasizes to the skin.
• Up to 25% of women with metastatic breast cancer may experience skin involvement, which can occasionally be the initial sign of the disease.
• Dermatologists play a crucial role in diagnosing breast cancer-related skin manifestations and can prevent unnecessary treatments for misdiagnosed conditions.
• Clinical presentations of breast cancer on the skin can vary widely, requiring a low threshold for biopsy in patients with a history of breast cancer.
• Common presentations include mammary Paget's disease and inflammatory breast cancer, both of which may be mistaken for conditions like eczema or cellulitis.
• Nodular metastatic carcinoma is the most common type of cutaneous metastasis from breast cancer, often appearing as pink papules or plaques.
• Triple-negative breast cancer is more likely to present with skin metastases and can be aggressive, often leading to severe manifestations early in the disease course.
• Treatment for skin metastases is primarily palliative, focusing on symptom relief and wound care, rather than curative interventions.
• Newer systemic therapies show promise in treating cutaneous metastases, indicating a need for a multidisciplinary approach to manage these complex cases.