Hello to everyone! I am always reading Lactnet posts, but this is my first
posting. I am an R.N.and a candidate to be L.C.
Here are some references Cindy requested ( I will probably not mention any
of this to the patient, but send her to see her gynecologist, and probably
call him to explain my observation of the pt.):
1) Philip J. DiSaia-William Creasman CLINICAL GYNECOLOGIC ONCOLOGY Fith
Ed.1997. Mosby pg.385-388 ("Close inspection of the skin and nipple of the
breast may reveal abnormalities suggesting an underlying malignant process.
Edema of the skin of the breast (peau d'orange=orange skin) is occasionally
subtle but is more often extensive. This condition is frequently more
prominent in the lower half of the breast than in any other region, and it
is most noticeable when the patient arms are raised. Althoug this edema is
often attributable to lymphatic obstruction from a deep-seeded carcinoma in
the breast, it may also be caused by extensive axillary lymph node
involvement with metastatic disease......Erythema of the skin of the breast
is an ominous sign. Although the cause may be inflammation such as
periductal mastitis or even abscess formation, inflammatory carcinoma
should be considered a possibility.")
2) Herbest-Mishell-Stenchever-Droegemueller M.D. COMPREHENSIVE GYNECOLOGY
Third Ed. Mosby 1997 pg. 367 photo 13-8 peau d'orange from underlying
carcinoma.
Saludos from Puerto Rico!
Gabriella L. Menegatto R.N. M.B.A.

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> From: Yousko's in Texas <[log in to unmask]>
> To:
> Subject: Orange peel skin
> Date: Friday, July 31, 1998 7:02 AM
>
> I am wrking w a client who is nursing her 5 da.old 2nd child. She was
> c/o of "bearable pain" in both brsts in medial area - between 3 & 6
> o'clock- she was not engorged- has PNS- no fever or red streaks- started
> beginning of day 3. During her preg. she was given prescript. cr to
> apply under breasts for yeast- no overt signs of yst. in Mo. or baby at
> present.  She is very big busted- the areas have marked pitting edema &
> somewhere I remember the term "orange peel" skin as possible sign of
> cancer. I was unable to find it in any of my resources including Lactnet
> Archives. She nursed her 1st, who is now 2, for 14 mths- stated had the
> "orange peel" skin and soreness w 1st chd. also, that eventually
> resolved- had 1x antibiotic trtmt for mastitis in L with 1st chd.
> Possibly poorly draining ducts?- wrked on positioning and tried a rolled
> up towel under lg breast for better support. Rec. crushed cabbage lves,
> cont. use of skin cr. for yeast under breasts- more airdrying
> underneath, etc. TC on 12 day- soreness gone- "orange peel" skin still
> present but less noticeable, no further signs of yst in Mo. or baby.
> Should I mention the cancer connection- (I would want refs. before I
> do.)? Any info. is greatly appreciated. This is my 1st post after being
> a Lactnut for 2 yrs.- until now, my questions have always been answered
> through general dicussions on Lactnet.
> Thanks, Cindy Y., RN, IBCLC
>