Question 223

Question:

Breast carcinomas often cause the skin of the breast to become puffy and pitted, resembling orange peel. The pits most likely correspond with which of the following?

Correct Answer: A.  Attachments of suspensory ligaments (retinacula cutis) to the dermis

Inflammatory carcinoma of the breast creates pitting classically referred to as an “orange peel” appearance on clinical exam. It produces a rapid increase in breast size, itching, redness and warmth of the overlying skin. There is usually no obvious lump, and likewise inflammatory carcinoma is often confused with mastitis on clinical exam. The pitting is caused by severe inflammation destroying the suspensory (Cooper’s) ligaments attaching breast tissue to the dermis, resulting in a dimpled “orange peel.” The remaining answers do not play a part in the pathogenesis of pitting in inflammatory carcinoma.