A 60 year old Caucasian female was treated with a left lumpectomy and axillary lymph node dissection in 1994 at age 48 for a T1c,pN1,M0 Stage IIA breast cancer. Postoperatively, she completed 4 cycles of Adriamycin and Cytoxan, with radiation therapy, followed by 5 years of tamoxifen therapy. The patient also reports a history of treatment for seborrheic keratoses and rosacea.
Two years ago she noted a small erythematous patch at the inframammary fold of the left breast. She notes that it would change colors at times going from pale to red to almost black. She now presents to your office for the first time for a second opinion. On exam there is a 1 by 1 cm erythematous raised area in the lateral portion of the inframammary crease.
Offer your professional perspective on diagnostic and surgical and adjuvant treatment options for this patient. An expert commentary will appear in the fall issue of the ASBD Advisor along with a summary of member comments.
