A 56-year-old woman came to our clinic with nodular, indurated, itchy, painful skin lesions over her left anterior chest wall that she had for a month. She was also experiencing lower back pain that had started 2 months before the skin lesions had developed. Thirteen years earlier, the patient had been diagnosed with breast cancer (infiltrating ductal carcinoma stage T2 N1 M0) and had undergone a left modified radical mastectomy. She was advised to receive chemotherapy and radiotherapy after the surgery, but refused further treatment.
During the examination, we noted multiple elevated, nodular, erythematous, indurated skin lesions over the left side of her anterior chest wall near the mastectomy scar that measured approximately 8 × 7 cm (FIGURE 1). The axillary lymph nodes were not swollen and there was no bone tenderness on palpation. The rest of the exam was normal.