Pleomorphic Appearance of Breast Cancer Cutaneous Metastases

Cutaneous metastases from breast cancer are relatively rare, occurring in about 10% of oncology patients, and can be the first sign of cancer in 1% of individuals without a previous cancer diagnosis. These skin lesions are highly variable in appearance and can mimic a wide range of benign and malignant skin conditions, infections, and other skin disorders. They often present as firm, flesh-colored to red nodules, papules, and plaques, and can appear in various locations including the chest wall, eyelids, and even in mastectomy scars or radiation therapy ports. Classic patterns such as carcinoma erysipelatoides, carcinoma telangiectoides, and carcinoma en cuirasse, as well as the newly observed carcinoma hemorrhagiectoides, are noted in breast cancer patients. Due to their diverse presentation, breast cancer cutaneous metastases can be mistaken for other conditions, making it crucial to consider them in the differential diagnosis of new or persistent skin lesions in patients with or without a history of breast cancer. A biopsy is essential for confirming the diagnosis.