Postoperative breast edema

Discussion:

Since it was clinically suggestive of an inflammatory breast carcinoma, a biopsy of the involved skin was done, which showed chronic perivascular dermatitis without malignant tumor cells.

The cause of the edema is the interruption of the lymphatic flow from the breast, due to axillary lymphadenectomy.

Unilateral breast edema and peau d'orange sign of the breast skin are the common appearance of many diseases ranging from breast lesions to systemic entities, and from benign to malignant lesions. Schematically they are:

  • mechanical problems such as: 
    • obstruction of the lymphatic flow due to axillary lymphadenectomy or axillary lymph node enlargement (metastatic, lymphoma, tbc …)
    • venous stasis due to axillary or subclavian vein occlusion
    • heart failure (rare)
  • infection (mastitis)
  • inflammatory, post radiotherapy edema, that arise following completion of radiation therapy
  •  inflammatory breast carcinoma (IBC)

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