In vivo reflectance confocal microscopy for detecting cutaneous metastasis in breast cancer

A 45-year-old female with a history of invasive ductal breast carcinoma (IDBC) presented with an asymptomatic erythematous nodule on the right mastectomy scar. Dermos copy revealed erythematous peripheral border, polymor phous and atypical vessels, focal scaling, and multiple white structureless areas appearing as white clods and strands. Reflectance confocal microscopy (RCM) revealed a normal epidermis with a preserved honeycombed pattern, with der mal tumoral clusters of varying sizes consisting of highly polymorphous hyporeflective cells with different sizes and shapes.