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Differential diagnosis of skin thickening on mammography

Dr Yuranga Weerakkody et al.

The presence of skin thickening on mammography is variably defined, usually being more than 1.5 - 3mm in thickness. It can result from a number of both benign and malignant causes. They include

Malignant

inflammatory breast cancer : one of the most concerning causes of skin thickening : this usually gives diffuse skin thickening
locally invasive breast cancer : tends to give focal skin thickening
lymphatic obstruction of metastatic axillary nodes
certain metastases to the breast
breast lymphoma

Benign

infection - mastitis
conditions causing fluid build up in the breast : tends to be bilateral although at times can be asymmetrical if the patient has been lying on a particular side prior to the mammogram
trauma to the breast
- mammary fat nacrosis
- burns to the skin overlying the breast with scarring
chronic graft-versus-host disease (GVHD) ²
breast irradiation : tends to be most prominent around 6 months after irradiation
certain dermatological conditions
- pseudoxanthoma elasticum ⁶

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