Figure 2b. Images obtained in a 64-year-old woman with a mass 6 cm in longest diameter in the upper outer quadrant of the left breast, peau d’orange, and nipple retraction. (a) Craniocaudal mammogram of the left breast shows diffuse skin thickening (arrowheads), trabecular coarsening, and a spiculated mass (arrows) 5.5 cm in longest diameter in the outer quadrant. (b) Transverse US scans show marked skin thickening (*) and dilated lymphatic channels (arrows) that are typical of the breast edema pattern. Hypoechoic masses are also seen. Histologic subtype and size: invasive ductal carcinoma, 6 cm in longest diameter.