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Case Reports in Dermatological Medicine
Volume 2012, Article ID 134938, 5 pages
http://dx.doi.org/10.1155/2012/134938
Case Report

Diverse Presentations of Carcinoma Erysipelatoides from a Teaching Hospital in Australia

1Department of Dermatology, St George Hospital, Sydney, NSW 2217, Australia
2Department of Anatomical Pathology, South Eastern Area Laboratory Service, St George Hospital, Sydney, NSW 2217, Australia
3University of New South Wales, Sydney, NSW 2052, Australia
4Cancer Research Program, Garvan Institute of Medical Research, Darlinghurst, NSW 2010, Australia
5Cancer Care, St George Hospital, Sydney, NSW 2217, Australia

Received 14 August 2012; Accepted 15 October 2012

Academic Editors: S. A. Cuevas-Covarrubias, R. Krishnan, and N. Oiso

Copyright © 2012 Hui Ting Chow et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Inflammatory breast carcinoma is a rare form of advanced breast cancer which carries a poor prognosis, even with treatment. Diagnosis is reached on clinical and pathological grounds; however, due to its propensity to mimic other conditions, it may often be delayed or missed by attending physicians. This case series describes four patients seen at our institution with a diagnosis of inflammatory breast cancer; 3 patients had a history of previously treated breast malignancy. In these cases, the emergence of a new breast lesion evaded initial diagnosis due to incomplete initial physical examination, falsely reassuring imaging results, lack of recognition that a cellulitis picture can resemble metastatic carcinoma, and inconclusive initial biopsy sections. These obstacles to achieve diagnosis serve to further worsen the prognosis by delaying the initiation of multimodality treatment which can improve survival. The purpose of our paper is to increase awareness among breast cancer specialists of the importance of undressing the patient for basic clinical examination of the breasts, recognition of the appearances of this type of local recurrence of breast cancer, and not to rely purely on ultrasound and mammography due to delay in diagnosis in some of our local cases. Sometimes deeper sections and repeat biopsies are needed to make the diagnosis.