Breast Cancer, Inflammatory

Hot Chest 2

Step 1: View clinicals

A 30 year old woman presents with redness, pain, and worsening swelling of her right breast for 2 weeks. There is no history of fever, itching, or trauma to the affected breast. Treatment with a 7-day course of oral antibiotics yielded no visible response. Her medical history is unremarkable, and there is no family history of malignancy. Her first child was born 7 months ago, and is still being breastfed.

Step 2: Order all relevant investigations

Complete Blood Count

WBC/DC: 8,000/mm3 (4,600-11,000) N: 70% L: 25% Hb: 12 g/dL (11-18) Plt: 300,000/mm3 (150,000-450,000)

C-Reactive Protein

C-reactive protein: 3.0 mg/L (normal: <6)

Ultrasound Breasts

The ultrasound scan of the right breast reveals skin thickening. No hypoechogenic or hyperechogenic lesions are noted. In the right axilla, a single central lymph node is enlarged. The left breast and axilla appear normal.

Mammogram Right Breast

The mammogram could not be performed, due to the patient experiencing pain.

Step 3: Select appropriate management

IV Antibiotics
Urgent Oncology Referral
Breastfeeding Counselling
Surgical Drainage

Score: ★★☆