Firm nodules on back
A 55-year-old woman asked her family physician (FP) to look at the firm nodules on her back that had developed 2 months earlier. When the FP applied pressure to the nodules, no fluid or material exited. Five years earlier, the patient had been given a diagnosis of breast cancer. Treatment included a right mastectomy (including a saline implant), reconstructive surgery, and adjuvant chemotherapy.
What's your diagnosis?
The FP originally thought the nodules were abscesses, but began to suspect that they might be metastases from her breast cancer. A punch biopsy was performed with local anesthesia. There was no abscess, fluid, or fatty tissue and the solid tissue was sent for pathology. Pathology came back and confirmed the FP’s suspicion.
The FP shared the results of the biopsy with the patient and referred her to an oncologist.
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Mayeaux, EJ. Breast cancer. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:551-556.
To learn more about the Color Atlas of Family Medicine, see: https://www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/
You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: https://usatinemedia.com/