Breast carcinoma presenting with upper limb lymphedema - A rare case

Area of Science:

• Oncology
• Lymphedema Research
• Diagnostic Imaging

Background:

• Lymphedema (LE) commonly arises post-breast cancer treatment (surgery, radiation).
• Axillary lymph node involvement by breast cancer can cause lymphatic obstruction and LE.
• LE presentation due to direct lymph node metastasis is infrequently reported.

Observation:

• A 50-year-old female presented with right upper limb lymphedema.
• Clinical examination revealed a suspicious breast mass but no bulky axillary lymphadenopathy.
• Breast edema complicated the initial clinical diagnosis of breast cancer.

Findings:

• Lymphoscintigraphy confirmed right upper limb lymphedema.
• Contralateral epitrochlear lymph node uptake suggested pre-existing subclinical lymphedema.
• Right breast carcinoma was diagnosed, with lymphatic involvement causing clinical lymphedema.

Implications:

• Early and thorough imaging (mammography, ultrasound, MRI, PET) is crucial for breast cancer diagnosis when lymphedema is present.
• Breast cancer diagnosis can be challenging with concurrent breast edema.
• This case underscores the diverse presentations of lymphedema in breast cancer patients.