Dermal Lesions in the Breast: Diagnostic Approach and Patient Education

Introduction to Dermal Lesions

The National Comprehensive Cancer Network recommends that patients understand dermal lesions may present as skin changes, which require proper evaluation to rule out serious conditions 1, 2

Skin changes such as erythema and dermal edema could suggest inflammatory breast cancer, according to the National Comprehensive Cancer Network 1, 2, 3
Nipple excoriation, scaling, and eczema may indicate Paget's disease of the breast, as suggested by the National Comprehensive Cancer Network 1, 2
Skin dimpling could be associated with underlying breast cancer involving Cooper's ligaments, although this specific fact is from a less preferred source 4

The National Comprehensive Cancer Network suggests that for any unusual skin changes around the breast, evaluation typically begins with a bilateral diagnostic mammogram with or without ultrasound 1, 2
If imaging results are normal but skin changes are concerning, a punch biopsy of the skin or nipple biopsy may be necessary, as recommended by the National Comprehensive Cancer Network 1, 2
For suspicious imaging findings, a tissue biopsy is recommended, with core needle biopsy being the preferred option, according to the National Comprehensive Cancer Network 1, 2
Patients should be advised to report any changes in the appearance of the lesion or development of new symptoms, as suggested by the National Comprehensive Cancer Network 2