Cutaneous nodules as a first presentation in triple-negative breast cancer

Out of all skin neoplasms, metastasis accounts for only about 2%, and breast cancer is the second commonest malignancy to metastasize to the skin after malignant melanoma. Although triple-negative breast cancer patients tend to have metastatic disease at presentation, cutaneous metastasis is unusual. In this report, we present a 47-year-old asymptomatic woman whose attention was drawn by her hairdresser to a scalp swelling 2 months prior to presentation. Similar swellings were noticed on the back, arms, and thighs. One month later, a left breast lump was noticed during a clinical breast examination by a physician. She was in good physical condition but had generalized cutaneous nodules. Further investigations revealed canon ball metastasis to the lungs, and histopathology with immunohistochemistry confirmed triple-negative invasive ductal carcinoma with cutaneous metastasis. Skin involvement in breast cancer signifies advanced disease. Therefore, high index of suspicion is necessary so as not to overlook early sinister nodules as benign dermatological condition.