Background
The differential diagnosis of a red breast is extensive and includes both benign and
malignant diseases. The literature documents patients who present with a red breast
with delays in diagnosis of inflammatory cancer. We recorded our institutional experience
prospectively in the evaluation, diagnosis, and treatment of a red breast.
Methods
Data were collected prospectively on patients who presented with a red breast during
a 14-month period. A retrospective review of final diagnosis and outcome was then
conducted. A PubMed and Ovid Medline literature search were performed.
Results
Twenty-two patients presented with a red breast. This number accounted for only 0.6%
(22/3,762) of patients evaluated in our breast center during this time period. Final
diagnoses were as follows: mastitis in 31.8%, breast abscess in 13.6%, erythematous
changes secondary to radiation therapy in 13.6%, cellulitis in 9.1%, and venous hypertension
in 9.1%. Other diagnoses included postradiation morphea, benign dermatologic inflammation,
Paget disease of the breast, inflammatory breast cancer, and psoriasis (1 patient
each). After treatment, 67% (17/22) patients had resolution of their symptoms and
18% (4/22) were improved. Only 1 (4.5%) of 22 patients had a change in diagnosis in
a median follow-up of 8.8 months.
Conclusion
A red breast is an uncommon presenting complaint in patients evaluated at a breast
center; however, the differential diagnosis is extensive. With appropriate diagnosis
and treatment, most patients will have improvement or resolution of their symptoms.
The diagnostic algorithm used by our breast center identified the cause of the red
breast correctly in >95% of patients at presentation, and it can serve as a guide
to evaluate patients with a red breast. This algorithm is in agreement with National
Comprehensive Cancer Network guidelines.
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Article info
Publication history
Published online: March 14, 2011
Accepted:
December 24,
2010
Footnotes
Supported by the Gundersen Lutheran Medical Foundation.
Identification
Copyright
© 2011 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
