<prompt> An elderly female presented with Peau de orange appearance of breast. What is it likely to be associated with?Drug reactionObstruction of cutaneous lymphaticsPost operative scarringTumour necrosis  <response>: The orange skin or peau d orange appearance is caused by swelling and oedema of the skin due to infiltration of dermal lymphatics, except at points where the dermis is anchored by these suspensory ligaments of the breast. This fibrous reaction is responsible for the spiculate features of a cancer. It is seen in chronic abscess and advanced breast cancer. Ref: Applied Basic Science for Basic Surgical Training edited by Andrew T. Raftery, 2008, Page 489; Bailey Loves 25th edition, Page 844 