A change in the color or texture of the skin of the breast or areola is an important symptom of breast carcinoma. The presence of dimpling, puckering, or scaliness warrants further investigation. The presence of unusually prominent pores, indicative of edema of the skin, is an important sign of malignancy. This clinical sign is called peau d'orange because of its orange-peel appearance. During the early stages of breast carcinoma, the lymphatic vessels of the breast are dilated and contain occasional emboli of carcinoma cells. Limited peau d'orange over the lower half of the areola is present. As the disease progresses, more lymphatic vessels become filled with carcinoma cells that block them, creating more generalized edema. The classic appearance of peau d'orange is pictured in Figure 16-7.
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