PMC7067122_01
(a-c) Pre-salvage chemotherapy (d-f) Post-salvage chemotherapy
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F1
About 1 year later, she represented with fibrosis of the left breast [Figure 1a, white short arrows], and palpable right axillary adenopathy. However, an 18F-fludeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) demonstrated an intense hypermetabolic activity associated with the right axillary adenopathy [Figure 1b, black arrows] and broad areas of moderate hypermetabolic activity throughout the left breast dermis and parenchyma [Figure 1c, white arrows]. Despite aggressive salvage chemotherapy with paclitaxel and carboplatin, an 18F-FDG PET-CT scan performed 4 months later revealed the progression of metastatic disease with spread to the right breast, with clinical images showing widespread cutaneous ulcerations and excoriations [Figure 1d-f].
Postsalvage chemotherapy biopsy
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F2
Metastatic spread to the right breast dermis was confirmed by punch biopsy which demonstrated invasion of lymphovascular spaces by tumor emboli [Figure 2, black short arrows] in a background of fibrous connective tissue.