What does skin dimpling or retraction indicate?

• A. Possible underlying malignancy
• B. Benign cosmetic change
• C. Normal aging
• D. Inflammatory dermatosis

Answer: (A)

Dimpling or retraction of breast skin is a warning sign for possible underlying malignancy. A growing tumor can pull on the suspensory ligaments (Cooper’s ligaments) and obstruct local lymphatics, causing the skin to tether and form dimples or puckering, sometimes more evident with movement or palpation. This finding prompts further workup with imaging (mammography and ultrasound) and often a biopsy to determine if cancer is present. It’s not a normal aging change and isn’t typical of benign cosmetic changes or inflammatory dermatoses, which tend to cause redness, warmth, swelling, or diffuse skin changes rather than focal skin tethering.