Can peau d'orange happen after lumpectomy?

[elms]

I had a lumpectomy in July 2003, re-excision in Aug 2003, (I had invasive ductal carcinoma, node neg.)started chemo in Sept (4 cycles of AC) Ever since my lumpectomy my breast has been swollen, sore, with the skin showing peau d'orange appearance. My nipple is inverted and thickened. I expressed concerns about this to my family doctor and my med. oncologist, both seemed to think it looked bad but didn't seem to think it was anything to worry about.  When I saw my radiation oncologist this past week I told her I was concerned with the way my breast looked and when she saw it she said "What is going on here?"

She won't do anything until I get a mammogram to rule out disease, which she said I should get ASAP. I am concerned that this could be Inflammatory breast cancer and won't show up on a mammogram.

I have 2 questions. Could the condition of my breast be a normal outcome of a lumpectomy?  If this is IBC, will a mammogram show anything to indicate a problem? The earliest I could get a mammogram was Dec 1.

[CCF-RN,MSN-JS]

Dear elms, Peau d'orange is a characteristic of the skin appearance when the lymphatic drainage in the area is disrupted for some reason.  This might occur on the skin overlying a tumor.  In inflammatory breast cancer the lymphatics of the skin are blocked by tumor cells, and swelling and skin changes occur.  Scarring could also block this drainage and cause the changes.  Further evaluation which is being done would further help to figure out what is going on specifically in your case.  The mammogram is a start.  Your surgeon should be aware of your continued problems and help with sorting this out.

[surgeon]

orange peel changes indicate swelling and fluid retention within the skin. It can occur from post op changes in some circumstances. I'd say the best person to evaluate the appearance and its significance is the surgeon who did the surgery.