What is Peau d’Orange breast – 6 Causes & treatments

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I. What is Peau d’Orange appearance? Orange peel skin meaning ;

The word Peau d’Orange has a French origin which means “orange peel skin” or “skin of an orange”. It describes the anatomical appearance of having a dimpled texture like that of an orange peel or an orange peel texture.

Some of  the conditions where peau d’ orange appearance is seen are:

  • inflammatory breast cancer
  • pseudoxanthoma elasticum (in the eye) and
  • elephantiasis.

It is also seen with myxedema of Grave’s disease, in addition to the above.

II. Causes for Peau d’Orange breast

Several medical conditions can lead to peau d’ orange breast:

1. Breast cancer– manifest as Peau d’Orange appearance

In inflammatory breast cancer, the cancerous cells do not form a tumor but rather infiltrate the lymphatic vessels. Consequently, this causes an accumulation of fluid in the breast (edema). Cutaneous lymphatic edema, along with tethering of the skin by the ligament of Cooper, leads to the appearance of a peau d’ orange texture.

In addition to peau d’ orange appearance, other symptoms of inflammatory breast cancer include:

  • swelling and redness of the breast (however, rash under the breast is caused by conditions other than cancer)
  • a pink, reddish, purple, or bruised appearance of the skin
  • a rapid increase in breast size can occur too
  • sensations of heaviness, burning, pain, or tenderness in the breast
  • an inverted nipple
  • swollen lymph nodes under the arm(axilla), near the collarbone, or both

diagnosis and treatments of inflammatory breast cancer below

2. Peau d’Orange breast Due to Lymphedema

It is a swelling occurring as a consequence of a blockage of the lymph vessels. It can be primary ( spontaneous) or secondary. The secondary lymphedema can be a result of:

  • cancer in particular 
  • therapy or surgery following malignant diseases
  • infections
  • chronic venous insufficiency
  • congenital disabilities
  • obesity

3. Peau d’Orange skin due to Cellulitis

It is a very common condition. The enlargement of underlying fat cells causes the skin to become bumpy and dimpled. As a result, a peau d’ orange occurs. This mostly appears on buttocks, thighs, hips, and abdomen. In addition, it might be reassuring to know that it occurs in the majority of the women after puberty.

4. Graves’ dermopathy can show Peau d’Orange

This occurs following an autoimmune disorder of the thyroid gland known as Grave’s disease. A build-up of certain types of carbohydrates in the skin leads to an orange peel texture. This skin change is most prominent in the shins and top of the feet.

5. Infection causing Peau d’Orange skin

Infection Of skin or soft tissue, causing swelling and peau d’ orange skin is rare but possible.

6. Pseudoxanthoma elasticum

Pseudoxanthoma elasticum is a condition that results in the hardening of elastic fibers present in the skin and connective tissues in the body. For that reason, these tissues lose their ability to expand and contract.

This loss of flexibility can lead to high blood pressure or angina, vision loss or peau d’ orange skin depending on the area of the body involved.

III. How to diagnose breast cancer?

breast cancer symbol
Breast cancer symbol

The diagnosis of breast carcinoma can be made by:

  • Physical examination: look for signs of inflammatory breast cancer (as mentioned above. Including peau d’ orange.)
  • Biopsy: take small tissue samples from the breast or the axillary lymph nodes and send for laboratory examinations.
  • Mammogram: This is a low-dose X-ray of the breast tissue. 
  • Ultrasound or other imaging tests: To provide a clearer picture and information on the extent and spread of the cancer cells.

IV. What are the treatment options for Inflammatory breast cancer?

Inflammatory breast cancer spreads fast. Therefore, it is necessary to start the treatment immediately following a diagnosis of breast cancer.

Treatment of breast cancer involves two approaches which include:

first,

  • Local: focusing specifically on the breast and secondly
  • Systemic: treatment of the body as a whole to reduce or manage the cancer spread.

These measures include:

  • Chemo-therapy: This is done before surgery to shrink a tumor or reduce the extent of cancer before removing it.
  • Surgery:  it can be the partial or total removal of a part or all of the tissue of one or both breasts. (mastectomy)
  • Radiation therapy: Radiation therapy is done after chemotherapy and surgery to destroy any remaining cancer cells
  • Targeted-therapy: Medications are used to block the growth of cancer cells, causing them to die.
  • Hormone-therapy: is done when the cancerous cells are sensitive/responsive to hormones. 

V. How to prevent inflammatory breast cancer?

The prevention of breast cancer is not entirely possible. We can, however, take steps to reduce the chances of its development:

  • Learn how to identify the symptoms such as peau d’orange
  • receiving regular screenings
  • maintain a healthy lifestyle
  • reduce alcohol intake
  • knowing about family history of cancer
  • breastfeeding

Share with your friends and ask any questions about breast cancer.


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