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Breast Cancer and Orange Peel Skin: What This Warning Sign Means
Most breast changes turn out to be harmless, but a few deserve attention right away. Skin that looks thick and pitted like the peel of an orange is one of them. Here is what that sign can mean, the other changes worth knowing, and who to call.
What Orange Peel Skin Looks Like
Doctors call it peau d'orange, French for skin of an orange. The skin of the breast becomes thick and swollen, and the pores look larger and deeper than usual. It happens when fluid builds up in the skin because the small lymph vessels that normally drain it are blocked.
Why It Can Be a Sign of Inflammatory Breast Cancer
The most important cause to rule out is inflammatory breast cancer, a rare and aggressive form of breast cancer in which cancer cells block the lymph vessels in the skin of the breast. It often does not form a lump that can be felt, and it may not show clearly on a mammogram.
The breast may become red, swollen, warm or heavy over a few weeks. Because it can look like an infection, it is sometimes treated with antibiotics first. If it does not clearly improve within about a week, it needs further testing.
Other Breast Skin Changes to Watch For
- A red, scaly or crusted patch on the nipple or areola that does not heal, which can be a sign of Paget's disease of the breast
- Redness or a rash over part of the breast
- Dimpling or puckering of the skin
- A nipple that turns inward or changes direction when it did not before
- A new lump in the breast or armpit
- Nipple discharge, especially if it is bloody or comes from one breast only
- A change in the size or shape of one breast
Many of these have harmless causes, such as eczema, an infection or normal hormonal changes. They are still worth checking, because the serious causes are easier to treat when found early.
Changes That Are Usually Harmless
Breasts are rarely perfectly symmetrical, and a difference that has always been there is normal. Dimpling can also come from an old injury. What matters most is change: something new, something on one side only, or something that keeps getting worse.
What to Do If You Notice a Change
Call your primary care doctor or gynecologist and describe what you see. Orange peel skin, a red and swollen breast, or a new lump should be checked within days, not weeks. The usual next steps are a breast exam, imaging such as a mammogram or ultrasound, and sometimes a biopsy.
A dermatologist can help when the change is in the skin itself, such as a rash, eczema or a scaly patch on the nipple, and will tell you promptly when anything needs a breast specialist.
Know Your Risk
Some factors raise the risk of breast cancer, including older age, a family history of breast or ovarian cancer, inherited gene changes such as BRCA1 and BRCA2, radiation to the chest at a young age, alcohol and obesity. Ask your doctor which screening schedule is right for you.
Before You Go
No. Infection, an injury, radiation treatment and conditions that cause swelling can all produce it. Because inflammatory breast cancer is one possible cause, it should always be checked promptly.
Often not. It usually shows as redness, swelling, warmth and orange peel skin rather than a lump, which is why skin changes matter.
Your primary care doctor or gynecologist for changes in the breast. A dermatologist for rashes and skin conditions on the breast, who will refer you on when needed.
Reading is a start. A visit is an answer.
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