The FP, who had palpated firm, matted nodes in the left axilla, immediately recognized the peau d’orange sign of breast cancer with lymphedema. (With this sign, the skin of the breast looks that of an orange as a consequence of lymphedema.)
The FP explained to the patient that she most likely had breast cancer and referred her to the local university breast center. While the prognosis appeared poor, the FP recognized the importance of making every effort to have the disease staged to determine the most appropriate therapies.
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Mayeaux, EJ. Breast cancer. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:551-556.
To learn more about the Color Atlas of Family Medicine, see: http://www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/
You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: http://usatinemedia.com/