The patient was a 48-year-old woman who underwent segmental mastectomy and axillay lymph node dissection for right breast cancer at the age of 34, when the pathological diagnosis was noninvasive ductal carcinoma, TisN0M0 and Stage 0. Postoperative radiation therapy was performed, but chemotherapy as well as hormone therapy was not done. Thereafter no findings of recurrence had been seen for three years. She had received once-a-year mammography since the age of 44 until 48, when grouped multiform calcifications appeared and the fine-needle aspiration cytology resulted in Class V. Core needle biopsy at our center provided the diagnosis of invasive ductal carcinoma. No metastatic foci were identified other than the local recurrence. Right mastectomy was thus performed. The histopathological diagnosis was invasive ductal carcinoma (scirrhous carcinoma), and extended lymphatic invasion involving the skin was identified. The patient has been on postoperative chemotherapy (FEC+docetaxel) and postoperative hormone therapy (tamoxifen) and has been free from recurrence up to now.
The patient had lymphatic invasion of the skin without associating with inflammatory change of the skin that is considered as occult inflammatory breast recurrence.