Which skin change on the breast skin is concerning for breast cancer?

• A. Erythema
• B. Petechiae
• C. Peau d'orange
• D. Telangiectasia

Answer: (C)

Lymphatic blockage causing skin edema produces peau d'orange, an orange-peel texture of the breast skin. Tumor cells can obstruct lymphatics in the skin, leading to edema that tethers the skin and gives this dimpled, citrine look. It’s especially associated with inflammatory breast cancer, where changes can appear rapidly with swelling, warmth, and sometimes redness alongside the peau d'orange.

The other signs are less specific: erythema is simply redness that can come from irritation or infection; petechiae are tiny spots from microbleeds and have many causes; telangiectasia are small dilated vessels that can appear with aging or other skin conditions and are not a hallmark cancer sign. So the orange-peel skin change is the one that most strongly points toward breast cancer involvement. If seen, it warrants prompt medical evaluation with imaging and biopsy as indicated.