A lecture by Dr/ Rania Alakad (dermatologist, Egypt) about 2 cases presenting with metastasis of cancer breast to the skin.

1. Rania Alakad
Assistant lecturer
Dermatology & venereology
department
Zagazig university

2. Case (1)

6. A skin biopsy was sent for
histopathological examination

7. Case (2)

9.  review of her medical
records showed that she
was diagnosed with
(invasive ductal
carcinoma left breast).
 treated with radical
mastectomy and three
cycles of radiotherapy.

14. A skin biopsy was sent for
histopathological examination

23. Cutaneous metastasis
of breast carcinoma

24. CUTANEOUS METASTASIS
OF BREAST CARCINOMA
 the most common skin metastasis encountered by
dermatologists. ( 24% of patients with breast cancer)
1. the 1st sign of tumour dissemination before other
organs.
2. the 1st sign of tumour recurrence.
3. Rarely the 1st sign of undetected malignancy.
 the lesions usually occur in the skin overlying the
area of the primary tumor.

25. CUTANEOUS METASTASIS
OF BREAST CARCINOMA
 not known.
 Perhaps Due to the
anatomical location of
the breast tissue and
extensive network of
breast lymphatics.
why breast
cancer
frequently
metastasize
s to skin??

26. MORPHOLOGICAL VARIANTS
 Solitary or multiple infiltrating papules and nodules
(most common).
 Carcinoma en cuirasse
 Carcinoma telangiectaticum.
 Alopecia neoplastica,
 Zosteriform pattern.
 Carcinoma erysipeloides.
 Ulcerative, pseudovesicular, purpuric lesions.
 Lymphangioma circumscriptum like lesions.

28. Pseudo
vesicular
Purpuric
Telengectatic

29. HISTOLOGICAL VARIANTS
Glandular
Indian file pattern of malignant cells in
between collagen fibers,
Lymphatic embolization by malignant
cells
Fibrotic
Epidermotropic changes

30. The background
erythema =
congestion of
blood vessels.Purpuric hue of
=aggregates of
RBCs & tumor cells
in the ectatic
superficial BV

32. PROGNOSIS
 The interval between mastectomy & local
recurrence is the most reliable indicator of the
survival time.
 The most preferred mode of treatment is
systemic chemotherapy
 the expected survival is less than 1 year at the
time of diagnosis.