A 79-year-old woman presented with a raised, firm nodule with associated erythema and ulceration on her left breast (Figure 1). Five years previously, she had undergone lumpectomy and radiation therapy for ductal carcinoma in situ of the ipsilateral breast. She reported thickening in the center of her left breast but denied breast pain, nipple discharge, or any systemic symptoms. A mammogram showed increased tissue density, edema, and architectural distortion of the left breast. Fine-needle aspiration revealed tumor cells that were estrogen- and progesterone-receptor negative. Magnetic resonance imaging was obtained (Figure 2).
Photograph of the left breast. Ruler units are centimeters.
Gadolinium-enhanced magnetic resonance image of the left breast.
A. Recurrent ductal carcinoma in situ
B. Invasive ductal carcinoma
D. Inflammatory breast cancer
Parekh J, Visser BC, Leong SPL. Image of the Month—Quiz Case. Arch Surg. 2005;140(8):809. doi:10.1001/archsurg.140.8.809