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October 21, 2021

Hand Foot Syndrome | Palmar-Plantar Erythrodysesthesia

Learn more about Hand Foot Syndrome

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Inflammatory Breast Carcinoma
October 04, 2021

Inflammatory Breast Carcinoma

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Inflammatory breast carcinoma is a rare type of breast cancer with an incidence of about 2 to 4% of breast cancer cases in the United States. In spite of its lower incidence, it does have a higher mortality at 7% of breast cancer related mortality.


Tatcha

 

 

When it occurs in the skin it can appear as redness or pink patches involving the skin of the breast. This may or may not have skin changes such as underlying induration or thickening of the skin. There is usually no underlying lump, nodule, or mass.

 

The cases that I have diagnosed have been a bit challenging in that the patients had not even considered breast cancer as a possibility. Actually most had thought the redness was a result of hives or other types of rashes. There was a little convincing involved in consideration of a biopsy as there is no underlying mass in many cases. It can be challenging for a patient to even consider this as a possibility. Often times I would have to outline the area and have the patient return in a couple of days to show or demonstrate that there is no fluctuation in the affected skin. Hives or other contact reactions will fluctuate or be somewhat dynamic in how they behave. This step helps these patients realize that there is a difference in behavior and appearance of the affected skin. 

 

They are diagnostic criteria to meet for inflammatory breast carcinoma to be diagnosed. According to the American Joint Committee on Cancer (AJCC) the following criteria must be met. 

 

  1. Rapid onset of breast redness or erythema, swelling +/- dimpling of skin / p’eau d’orange skin changes, +/-  warmth of breast skin, +/- underlying mass. 
  2. Duration for less than six months. 
  3. Erythema or redness occupying at least 1/3 of the breast. 
  4. Biopsy confirmation of carcinoma

 

 

According to the American Cancer Society, inflammatory breast carcinoma tends to occur in women younger than the age of 40. This is concerning as routine breast cancer screenings via mammograthy generally start after the age of 40.

 

According to the American Cancer Society, inflammatory breast carcinoma is more often seen in African-American women than white women. This is also concerning to me as sometimes the subtle features that this type of breast cancer can present as initially may be difficult to recognize or diagnose. Palpation of the skin of the breast is essential to evaluate for any thickening or changes in the texture of the skin. Also recognizing that other features such as nipple inversion and the p’eau d’orange skin changes may be the clues needed to identify these cases. Unless there is an awareness to look for these changes it may be difficult to diagnose early.

 

 

All inflammatory breast carcinoma is stage III at diagnosis because it involves the skin at the time of diagnosis. If you are routinely having skin exams, but not yet having breast examinations by your gynecologist, it is important to point this out to your dermatologist so that examination of the skin of the  breast can be included in your skin cancer screening. If you note any changes in the skin of the breast that are of concern to you, please point these out to your dermatologist so that a biopsy  and further work up can be considered.

 

 





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Skin changes associated with Chemotherapy for Breast Cancer
October 03, 2021

Skin changes associated with Chemotherapy for Breast Cancer

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basal cell carcinoma breast cancer
September 30, 2021

Breast Cancer & Basal Cell Carcinoma

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Basal cell carcinoma is the most common form of skin cancer with most associated with UV exposure. Breast cancer is the second most common form of cancer that can affect women. Annual skin cancer screenings are recommended to detect skin cancer starting as early as the age of 18 while mammograms are recommended for early detection of breast cancer starting at either the age of 40 or 45. 

 Age /Gender
Recommended Health Screenings
Frequency
18-39

Annual

Weight & Height

Blood pressure

Skin Cancer Screening

Depression Screening

Cholesterol (if risk factors)

Blood work as discussed with your primary

18-64 Every 3 years

Pap smears for women

40 or 45 and above Annual

Mammogram for women

45 or 50 and above Varies based on risk factors

Colonoscopy

50 and above  Annual

Prostate screening






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People with multiple skin cancers such as basal cell carcinoma are at higher risk for breast cancer in addition to cancers of the colon, prostate, and blood. The increased susceptibility is most likely from mutations in genes that normally code for proteins that work to repair the DNA of our cells.  A recent study showed that people who had 6 or more basal cell carcinomas in a 10 year period of time were 3x more likely to develop an unrelated cancer such as breast, colon, prostate or blood. The specific genes reviewed in this study were APC, BARD1, BRCA1, BRCA2, CDH1, CHEK2, MLH1, MSH2, MSH6, MUTYH, NBN, and PALB2. 

 

In terms of some specific genes, an increased risk of breast cancer has been associated with BRCA1 and BRCA2 gene mutations. Some studies have demonstrated that women with the BRCA2 gene mutation may carry a slightly higher risk of both melanoma and basal cell carcinoma. These findings have not been consistently found in various studies so it is difficult to state with certainty if there is a direct connection.


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The key to understanding the important of this information is to recognize that in those individuals with multiple basal cell carcinoma diagnoses, it is worth discussing with your healthcare provider the role that earlier screenings or closer surveillance can play in cancer detection.

 







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Paget Disease of the Breast by Dr Erum Ilyas
September 30, 2021

Paget Disease of the Breast

Learn more about Paget Disease of the Breast

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