Cutaneous Presentations of Metastatic Carcinoma Breast: A Case Series

Skin is an outer reflection of our overall health. Cutaneous metastases occur due to the persistence or recurrence of primary solid tumors. It occurs in 0.7 to 10.4% of all patients diagnosed with cancer, although they represent only 2% of all skin tumors. Cutaneous metastasis from breast carcinoma has varied presentations with different morphologies and appearances. It presents as red, firm papules, nodules, or plaques with either smooth, crusted, or ulcerated surfaces over ipsilateral chest wall. However, it can occur at some unusual sites like the scalp, eyelids, inframammary area, arms, umbilicus, nails, and mastectomy scar. Skin lesions of breast cancer metastases can be confused with some benign cutaneous lesions (cysts, dermatofibroma), skin malignancies (melanoma and non-melanoma skin cancers), infections (folliculitis, pyoderma, erysipelas, herpes zoster), dermatological conditions (dermatitis, hidradenitis suppurativa), reactive erythemas (urticaria, insect bite hypersensitivity), and vascular conditions (petechiae, purpura, pyogenic granuloma, angiosarcoma). Carcinoma en cuirasse, carcinoma erysipeloides, carcinoma telangiectoides, and carcinoma hemorrhagiectoides are various patterns of skin metastases. Concerning morphology and appearance, a dermatologist should have adequate knowledge to recognize and evaluate such patients, with or without a history of breast cancer, for early detection of metastasis and further treatment. Here, we report a case series of 10 patients with diverse appearances of metastatic breast cancer that could mimic other dermatological conditions.