A 58-Year-Old Woman Develops a Pruritic, Erythematous Plaque Involving the Areola


A 58-year-old woman, previously in excellent health, noted the insidious development of a unilateral, irregularly annular, modestly pruritic, erythematous patch/plaque involving the edge of the areola and extending onto the contiguous skin. By history, the affected skin occasionally wept clear fluid that formed a superficial crust. Periodic application of over-the-counter 1% hydrocortisone relieved itching and weeping, but the lesion itself persisted and expanded. Past medical and social histories were unremarkable. Family history disclosed that one of two sisters died of complications from breast cancer. Despite this history, the patient had not obtained a mammogram in over five years. Her primary care physician referred her for dermatologic consultation due to “intractable eczema.”

What is the likelihood that this individual has either in situ or invasive ductal breast carcinoma?

A. 5% to 15%
B. 20% to 45%
C. 50% to 75%
D. 75% to 85%
E. > 90%