A 3 year ulcer!

30 December, 2006 at 3:10 pm gcgeorge 15 comments

Another teaser – easy so I will omit all hints!

Need help – ask for hints!

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Written by susan on 31 December, 2006.

look so gross! Anal? donola! What happened to the patient? How could he/she waited so long to get treated?
Written by George on 31 December, 2006.

Fear keeps people from seeking advice – fear of the truth, the pain, the future.

No not anal. somewhere higher in the body!
Written by acidulous on 31 December, 2006.

Hmm…the margin of the ulcer look heamorrhagic and the ulcer seem to be suppurative… is it at the breast haha… just a wild guess…
Written by George on 31 December, 2006.

Hi acidulous, thanks for droping by and making an extremely correct observation — a haemorrhagic suppurative ulcer of the breast — but….. what is it actually?
Written by Doc on 1 January, 2007.

Yummy! BCC perhaps, or just an advanced breast ca
Written by Bernard on 2 January, 2007.

Ulcerating Ca breast.

What did you do?
Written by George on 2 January, 2007.

I did a mastectomy with axillary clearance and she went home after 4 days.
Written by George on 3 January, 2007.

Ooops she developed some wound breakdown in the centre where it is most tight.
Written by Bernard on 3 January, 2007.

I guess a small, clean, healing wound is still much better than the ulcerating lesion she had initially. Is she getting RT as well?
Written by George on 4 January, 2007.

true and she so cheerful, thus the happiness. I would give her RT to the chest wall but later.
Written by hoiling on 7 January, 2007.

Hi there, I really wonder. What causes such ulcer? Started out as small tiny wound until it get developed till this size and rate? I thought our skin has self-heal ability???
Written by george on 7 January, 2007.

The skin has self -heal ability true when the tissue is normal.
In cancer, which by definition is an abnormal tissue growth with unconrolled growth. Therefore, it normally starts as a nodule, a lump and because its growth is independent of the host(man) it enlarges. The rate of its growth depends on the type of cancer cells. As the size increases, it compresses the surrounding normal tissue and also occasionally steals the blood supply. This causes the normal tissue to die. If it is close to the skin, the skin will die and necrose and then ulcerate. It fails to heal because the cancer would continue to grow and more normal tissue will die and the ulcer will get bigger. That is the story.
Written by hoiling on 10 January, 2007.

Oh ..the pictures you featured here are not common wound but cancer associated. aww ..scary. I wonder if most of breast cancer looks like this? Why don’t just cut if off? How long the old lady can live with tht condition should she refuse medical help?
Written by George on 10 January, 2007.

Well, This usually occurs in advance cases. Most breast cancer are not visually obvious. They normally begin as a nodule – a small one which most often can only be felt and smaller ones by ultrasound. This is why the breast self examination is a simple yet important and effective way to detect any lumps early. Again, not all lumps are cancers but all lumps must be investigated properly.

As to cutting it off, we wanted but the patient refused initially. A week later, she agreed and we remove the whole left breast with the cancer and the lymph nodes in the armpit(axilla)

How long? Well it is already advance. She will require further investigations and the risk of it coming back is high. The reason for removal is so that she could have a better quality of life and also prevent her from losing blood any further. This is no more a surgery to cure but to palliate.
Written by George on 10 January, 2007.

Please refer to Breast Cancer Awareness Month for method of assessing lumps:
http://med97um.net/george/index.php/2006/10/05/breast-cancer-awareness-month