Peau d’orange in carcinoma breast is due to:(AIIMS November 2015, DNB 2012, PGI June 95, December 95)
**Core Concept**
Peau d'orange, also known as "orange peel skin," is a clinical manifestation characterized by a skin texture resembling an orange peel. This condition is often associated with breast cancer, particularly in cases where the tumor has spread to the lymph nodes and the skin, leading to lymphedema and subsequent skin changes.
**Why the Correct Answer is Right**
The correct answer is related to the obstruction of lymphatic vessels by cancer cells, which leads to lymphedema. This obstruction prevents the normal drainage of lymph fluid, resulting in the accumulation of fluid in the skin and subcutaneous tissue. As a result, the skin becomes thickened, edematous, and develops a characteristic peau d'orange appearance. The lymphatic obstruction is caused by the infiltration of cancer cells into the lymphatic vessels, which is a common feature of breast cancer.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not directly relate to the pathophysiology of peau d'orange in breast cancer. While inflammation can cause skin changes, it is not the primary mechanism responsible for peau d'orange.
**Option B:** This option is incorrect because it refers to a different clinical condition altogether. Erythema is a redness of the skin, often caused by inflammation or infection, but it does not explain the characteristic peau d'orange texture.
**Option C:** This option is incorrect because it mentions a type of skin cancer, but peau d'orange is a manifestation of breast cancer, not skin cancer.
**Option D:** This option is incorrect because it refers to a different type of skin lesion altogether. Seborrheic keratoses are benign skin growths that do not cause peau d'orange.
**Clinical Pearl / High-Yield Fact**
Peau d'orange is a classic sign of inflammatory breast cancer, a rare but aggressive subtype of breast cancer that is characterized by rapid progression and a poor prognosis. It is essential for clinicians to recognize this sign and investigate further to rule out underlying malignancy.
**Correct Answer:** C.