Skin retraction: Skin abnormally pulled in, tethered, concave, dimpled
Skin invasion: Tumor extends into skin, usually directly overlying tumor
Skin retraction does not = skin invasion
Usually shows associated skin thickening
Peau d'orange = skin resembling peel of orange: Thickened, with prominent skin pores, often also erythematous
Implies lymphatic edema, usually seen with inflammatory carcinoma
Skin thickening: Thickness > 2 mm; can be focal or diffuse
Normal skin may be thicker in periareolar region, inframammary fold, parasternally
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Provencher L et al: Is clinical breast examination important for breast cancer detection? Curr Oncol. 23(4):e332-9, 2016
Pereira O et al: Treatment of skin depression with combined upward suture traction and percutaneous subcision. Plast Reconstr Surg Glob Open. 3(10):e534, 2015
Morris EA et al: Breast Imaging Reporting and Data System: BI-RADS, Magnetic Resonance Imaging. 2nd ed. Reston: American College of Radiology, 2013
Mendelson EB et al: Breast Imaging Reporting and Data System: BI-RADS, Ultrasound. 2nd ed. Reston: American College of Radiology, 2013
Sickles EA et al: Breast Imaging Reporting and Data System: BI-RADS, Mammography. 5th ed. Reston: American College of Radiology, 2013
Uematsu T: MRI findings of inflammatory breast cancer, locally advanced breast cancer, and acute mastitis: T2-weighted images can increase the specificity of inflammatory breast cancer. Breast Cancer. 19(4):289-94, 2012
Edge SB et al: AJCC Cancer Staging Handbook. 7th ed. New York: Springer, 2011
Günhan-Bilgen I et al: Inflammatory breast carcinoma: mammographic, ultrasonographic, clinical, and pathologic findings in 142 cases. Radiology. 223(3):829-38, 2002
Padhani AR et al: Magnetic resonance imaging of induration in the irradiated breast. Radiother Oncol. 64(2):157-62, 2002
Le Gal M et al: Mammographic features of 455 invasive lobular carcinomas. Radiology. 185(3):705-8, 1992
Sickles EA: Practical solutions to common mammographic problems: tailoring the examination. AJR Am J Roentgenol. 151(1):31-9, 1988
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Definitions
Skin retraction: Skin abnormally pulled in, tethered, concave, dimpled
Skin invasion: Tumor extends into skin, usually directly overlying tumor
Skin retraction does not = skin invasion
Usually shows associated skin thickening
Peau d'orange = skin resembling peel of orange: Thickened, with prominent skin pores, often also erythematous
Implies lymphatic edema, usually seen with inflammatory carcinoma
Skin thickening: Thickness > 2 mm; can be focal or diffuse
Normal skin may be thicker in periareolar region, inframammary fold, parasternally
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Provencher L et al: Is clinical breast examination important for breast cancer detection? Curr Oncol. 23(4):e332-9, 2016
Pereira O et al: Treatment of skin depression with combined upward suture traction and percutaneous subcision. Plast Reconstr Surg Glob Open. 3(10):e534, 2015
Morris EA et al: Breast Imaging Reporting and Data System: BI-RADS, Magnetic Resonance Imaging. 2nd ed. Reston: American College of Radiology, 2013
Mendelson EB et al: Breast Imaging Reporting and Data System: BI-RADS, Ultrasound. 2nd ed. Reston: American College of Radiology, 2013
Sickles EA et al: Breast Imaging Reporting and Data System: BI-RADS, Mammography. 5th ed. Reston: American College of Radiology, 2013
Uematsu T: MRI findings of inflammatory breast cancer, locally advanced breast cancer, and acute mastitis: T2-weighted images can increase the specificity of inflammatory breast cancer. Breast Cancer. 19(4):289-94, 2012
Edge SB et al: AJCC Cancer Staging Handbook. 7th ed. New York: Springer, 2011
Günhan-Bilgen I et al: Inflammatory breast carcinoma: mammographic, ultrasonographic, clinical, and pathologic findings in 142 cases. Radiology. 223(3):829-38, 2002
Padhani AR et al: Magnetic resonance imaging of induration in the irradiated breast. Radiother Oncol. 64(2):157-62, 2002
Le Gal M et al: Mammographic features of 455 invasive lobular carcinomas. Radiology. 185(3):705-8, 1992
Sickles EA: Practical solutions to common mammographic problems: tailoring the examination. AJR Am J Roentgenol. 151(1):31-9, 1988
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