Right Breast Carcinoma with Serosanguinous Ulcer in a 65-Year-Old Female: A Case Report

Abstract

Breast cancer is the most common malignancy among women worldwide. While most cases present with a palpable mass, cutaneous involvement such as ulceration and serosanguinous discharge is less commonly emphasized and may delay diagnosis, particularly in elderly patients. A 65-year-old female presented with a five-year history of a progressively enlarging right breast lump that had recently ulcerated with serosanguinous and purulent discharge, accompanied by fever, nausea, and anorexia. She had no prior medical evaluation for the mass. Vital signs were stable except for tachycardia (110 bpm). Laboratory findings revealed marked leukocytosis (31.2 × 10³/µL), mild hyponatremia (133 mEq/L), and stage 2 chronic kidney disease (eGFR 60 mL/min/1.73 m²). Core needle biopsy of the breast mass demonstrated invasive carcinoma of no special type (NST), grade III, with no lymphovascular invasion and low tumor infiltrating lymphocytes (<5%). Initial management included intravenous ceftriaxone, analgesics, antiemetics, and wound care. This case highlights the importance of prompt histopathologic diagnosis in ulcerated breast lesions to differentiate malignancy from benign conditions. Delayed presentation remains a challenge in elderly populations. Comprehensive oncologic staging and definitive multimodality therapy are essential for optimal outcomes.