Breast Skin Conditions

Changes involving the skin of the breast are common and can have many causes, including irritation, inflammation, infection and other benign breast or skin conditions. Some breast cancers can also cause visible skin changes, so a new or persistent change should be evaluated when the cause is not clear.

What Breast Skin Changes Should Be Evaluated?

Breast skin can change in color, texture, thickness or appearance. Some changes develop suddenly, while others may persist or gradually become more noticeable. Symptoms that may warrant evaluation include:

• Redness or another new change in skin color
• Warmth or swelling of the breast
• Persistent rash, itching or irritation
• Scaling, flaking or crusting of the skin
• Thickening, dimpling or puckering of the breast skin
• Skin that develops an orange-peel appearance
• Persistent changes involving the nipple or areola
• Skin changes occurring with a new lump, nipple change or breast pain

Most breast skin changes are not caused by cancer. However, appearance alone cannot always determine whether a change originates in the skin, the breast tissue beneath it or another condition, particularly when symptoms persist or occur with other breast changes.

What Can Cause Changes to the Skin of the Breast?

Breast skin changes can develop for many reasons, ranging from common skin irritation to conditions involving the breast tissue itself. The appearance of the change, how quickly it developed and whether other symptoms are present can help your care team determine what type of evaluation may be appropriate.

Skin Irritation and Benign Conditions

Rashes, dermatitis and other skin conditions can cause redness, itching, dryness, scaling or irritation involving the breast. Injury, friction and changes following breast procedures or surgery can also affect the skin. When symptoms persist or their cause is uncertain, evaluation can help distinguish a skin condition from a change involving deeper breast tissue.

Mastitis, Inflammation and Infection

Mastitis is inflammation of breast tissue that can cause redness, warmth, swelling and pain. It commonly occurs during breastfeeding, although breast inflammation can occur at other times as well, and infection may sometimes be present. Depending on the cause, treatment may include supportive care or medication when an infection is identified or suspected.

Because inflammation and infection can sometimes resemble other breast conditions, symptoms that do not improve as expected, become worse or continue to spread should be reevaluated.

Breast Cancer and Inflammatory Breast Cancer

Some breast cancers can cause changes involving the skin or nipple. Inflammatory breast cancer, an uncommon but aggressive form of breast cancer, can cause relatively rapid redness or discoloration, swelling, thickening, warmth, dimpling or an orange-peel appearance and may occur without a distinct breast lump.

Persistent scaling, crusting or irritation involving the nipple or areola should also be evaluated. Benign skin conditions can cause these symptoms, but similar changes can occasionally occur with Paget disease of the breast. These symptoms do not mean that cancer is present, but evaluation is important when a new change persists or cannot be readily explained.

How Are Breast Skin Changes Evaluated?

Evaluation begins with a discussion of when the skin change began, how it has changed over time and whether you have noticed other symptoms such as pain, swelling, a breast lump or nipple changes. A clinical examination can help determine whether the finding appears to involve primarily the skin, the breast tissue beneath it or both.

Depending on your symptoms, age, examination and previous breast imaging, diagnostic mammography, ultrasound or other testing may be recommended. If a skin or breast finding remains suspicious or its cause cannot be determined through examination and imaging, a biopsy or other evaluation may be needed to establish a diagnosis.

Imaging is one part of the evaluation and is considered together with the clinical findings. A persistent or concerning breast skin change may require further evaluation even when initial imaging does not identify a clear abnormality.

Learn more about Breast Evaluation & Screening.

When Should I Contact the Breast Center?

Contact your healthcare provider or the Breast Center if you develop a new or persistent change in the skin of the breast, particularly if it is worsening, spreading or accompanied by swelling, a lump, nipple changes or other new breast symptoms. Rapidly developing redness, warmth or swelling should also be evaluated, especially when symptoms do not improve as expected.

You do not need to determine whether a breast skin change is caused by the skin itself, the breast tissue beneath it, an infection or another breast condition before seeking care. The Margie Petersen Breast Center can evaluate your symptoms and coordinate imaging or additional testing when appropriate.