Could my rash be breast cancer?

According to leading breast cancer surgeon Associate Professor Sanjay Warrier, while the chance of a rash being breast cancer is generally low, more women need to know the signs to look out for if a rash does appear.

“If you take off your shirt and find a flare-up of spots, redness or itchiness it is easy to spiral into a storm of stress. However, the truth of the matter is that most rashes can occur anywhere on your body – including your breasts – making breast rashes fairly common,” Associate Professor Warrier said.

“Rashes can be uncomfortable, unsightly, worrisome, and certainly surprising when they pop up in sensitive areas like your breasts or nipples. Of course some breast rashes are more problematic than others – and it is not always easy to tell the difference between the two.

“As a general rule of thumb, to distinguish the nasty from the mild, any rash that can be treated with over the counter topical creams in less than a few weeks is mild. However, if a rash involving your breast or nipple persists, swells, becomes painful, oozes, or leads to a fever, it is important to see your GP.”

According to Associate Professor Warrier, there are two key forms of breast cancer that are associated with breast rashes. He breaks down how to tell if your rash is associated with one of these rare forms of breast cancer.

Paget’s Disease of the Breast

“I should start by saying that Paget’s Disease of the breast or nipple accounts for less than five percent of all breast cancer cases in Australia. This rare form of breast cancer occurs when cancer cells amass in or around your nipple, which can affect the ducts of your nipple, as well as the outside of the nipple and areola,” Associate Professor Warrier explained.

According to Associate Professor Warrier, if you have Paget’s Disease of the breast you will likely notice rash-type symptoms on one breast.

“The skin condition you might notice with Paget’s Disease is scaly, red and itchy skin. While this condition is most common in women over the age of 50, if your symptoms match up you should visit a doctor as soon as possible because more than 97 percent of people who have this condition also have cancer elsewhere in their breast,” Associate Professor Warrier added.

Inflammatory Breast Cancer (IBC)

“This form of cancer only accounts for one to five percent of all breast cancers. However, while it is rare, it is also very specific – and it is important to know its signs,” Associate Professor Warrier said.

According to Associate Professor Warrier, the distinctive symptom associated with IBC is commonly known as ‘peau d’orange’, which is a thickened area of skin that is dimpled resembling an orange. In addition to this rash-type appearance, sufferers’ nipples may become tender, itchy or even discharge, or one breast may look significantly bigger than the other.

“Once again, I strongly recommend that anyone with these symptoms should see their GP immediately,” Associate Professor Warrier said.

According to Associate Professor Warrier there are six other common causes for breast rashes that people should look out for:

• Intertrigo – A sweat irritation that is caused from the folds of your skin rubbing against each other, or where your clothing or bra meet. This is one of the most common rashes seen by dermatologists, and typically appears underneath or between the breasts. This irritation can lead to yeast or other bacterial growth, which is why patients should aim to keep the affected skin clean, cool and dry to help it clear.

• Contact Dermatitis – An itchy rash that occurs when your skin comes into close contact with something it is allergic to or is irritated by. Commonly, this condition can be connected to the dyes and fabric finishes in clothing, fragrances and detergents, which is why it develops on the breasts. In order to ease the itch, you simply need to avoid whatever if causing it – and if you can’t work it out, see a dermatologist.

• Yeast Infection – Obviously a yeast infection is not commonly associated with your breasts, however it is not unusual to be found on the areola of nursing mothers. A yeast infection is a fungal yeast infection that can be identified by irritated, shiny, painful or flaky nipples. Topical or oral antifungals can help, though sanitising everything and regularly washing your bras can cool off the symptoms. It is important for breast-feeding mothers to see their GP if they believe they have a yeast infection.

• Eczema, Psoriasis, and other common skin rashes - scabies, hives, shingles. These are all common rashes and they do not discriminate which part of the body they show up on. If a rash appears of your breasts, as well as other places on your body, you should book into a dermatologist.

• Heat Rash – When your sweat ducts trap sweat under your skin, red lumps that can feel prickly, itchy and uncomfortable can grace your breasts. This skin condition occurs primarily in hot, humid weather, so it tends to go away on its own when your skin has a chance to cool down.

• Mastitis – A build-up of milk inside your breasts triggered by a clogged milk duct, or something else preventing the flow of milk, can occur for breastfeeding mothers. The affected breast tissue commonly swells, becomes red and warm to the touch. Breaks in your skin or nipples can lead to an infection, which can be treated under the guise of your GP with frequent nursing, using a warm pack before your feed, and in some cases antibiotics.

Associate Professor Sanjay Warrier is the immediate past President and current committee member of Breast Surgeons of Australia and New Zealand (BreastSurgANZ). His views are those of his own, not BreastSurgANZ. Associate Professor Warrier’s surgery is located at the Chris O’Brien Lifehouse. He is published in numerous peer-reviewed journals and won the Royal Prince Alfred Hospital’s Patron’s Prize for best scientific research.

www.drsanjaywarrier.com.au