Diffuse Dermal Angiomatosis of the Breast Clinically Mimicking Cellulitis and Inflammatory Breast Cancer.

A 40-year-old woman admitted for hyponatremia and anasarca due to decompensated cirrhosis after a recent steroid taper developed extremely painful cutaneous breast lesions clinically mimicking cellulitis and inflammatory breast cancer and was biopsy-diagnosed instead with diffuse dermal angiomatosis (DDA) of the breasts, a rare and painful disease that can be a diagnostic chameleon. This case highlights the importance of early surgical consultation and tissue biopsy to correctly diagnose the etiology of severely painful mastitis and prevent prolonged symptomology and repeated administrations of ineffective treatments. Diffuse dermal angiomatosis should be considered when suspected breast cellulitis is refractory to treatment or there is concern for inflammatory breast cancer, especially in pendulous-breasted women with comorbidities that increase susceptibility to local tissue hypoxia.

Risk Factors for Re-Excision Following Breast-Conserving Surgery.

PURPOSE/OBJECTIVES: To identify previously unstudied factors predicting re-excision following breast-conserving surgery (BCS) and to assess the feasibility of obtaining data about breast density for predictive modeling.
. DESIGN: Retrospective secondary data analysis.
. SETTING: Data were obtained from the cancer registry and electronic health records (EHRs) at Texas Health Harris Methodist Hospital, a large, urban, private, nonprofit hospital in North Texas.
. SAMPLE: 244 patients choosing BCS from 2011-2012.
. METHODS: Data were subjected to univariate analyses (chi-square) followed by logistic regression.
. MAIN RESEARCH VARIABLES: The primary dependent variable was re-excision following BCS. Predictors of interest included lifestyle factors, time from diagnosis to surgery, surgical approach, patient age, and breast density, and controlled for covariates, such as assay results.
. FINDINGS: Three factors predicted re-excision with 87% accuracy. CONCLUSIONS: Women younger than 60 years whose surgery included placement of a wire for localization of tissue to be removed and who underwent surgery soon after diagnosis are the least likely to require reoperation after BCS. Data integrity is critical to the success of research using EHRs and registry information.
. IMPLICATIONS FOR NURSING: Nurses may improve patient outcomes by helping women considering BCS solve problems that may delay surgery. Nurses can contribute to the success of nursing research by thoroughly and accurately recording patient information in EHRs.