A case report of lymphedema as an unusual initial presentation of breast carcinoma

Abstract

Breast carcinoma is one of the most common carcinomas among women around the world. Most of the women with breast carcinoma will present with signs and symptoms of breast problems to the health facility. Upper limb swelling is one of the rare initial presentations although it is rather common in patients as a sequelae of breast carcinoma treatment. We herein would like to report a case where a post-menopausal female presented with left upper limb swelling with initial history suggestive of traumatic injury of biceps muscle. Subsequent investigations of ultrasound, mammography, biopsy sample of the left breast found that the left upper limb swelling was due to a newly diagnosed invasive lobular carcinoma of the breast, staging of cT4cN2Mx which caused a rapidly progressing stage 2 lymphedema of the left upper limb. Lymphedema of the upper limb is a common complication of breast carcinoma treatment, especially those who require axillary lymph nodes clearance. Breast carcinoma with initial presentation of lymphedema of the upper limb is rare. Due to the rare presentation, diagnosis of breast carcinoma can be delayed. Clinicians should have high awareness to exclude breast cancer when a patient presents with unilateral upper limb swelling.