Differential Diagnosis for Painful Breast with Anemia and High LDH
- Single Most Likely Diagnosis
- Inflammatory Breast Cancer: This is a highly aggressive form of breast cancer that can cause pain, swelling, and skin changes in the breast. The anemia could be due to chronic disease or tumor-related effects, and high LDH (lactate dehydrogenase) is a marker of tissue damage and necrosis, which can be elevated in aggressive cancers.
- Other Likely Diagnoses
- Breast Abscess or Infection: A bacterial infection of the breast tissue can cause pain, swelling, and fever. Anemia could result from chronic infection or inflammation, and LDH might be elevated due to tissue damage.
- Fat Necrosis: This is a condition where the fatty tissue in the breast becomes damaged, often due to trauma, surgery, or radiation. It can cause pain, swelling, and skin changes, and might lead to anemia and elevated LDH if there is significant tissue damage.
- Do Not Miss Diagnoses
- Metastatic Disease: Although less likely, it's crucial not to miss the possibility of metastatic disease to the breast from another primary cancer site, such as the lung, melanoma, or gastrointestinal tract. High LDH and anemia could indicate widespread disease.
- Lymphoma: Both Hodgkin and non-Hodgkin lymphoma can involve the breast and cause pain, swelling, and systemic symptoms like anemia. Elevated LDH is a poor prognostic marker in lymphoma.
- Rare Diagnoses
- Granulomatous Mastitis: A rare inflammatory condition of the breast that can mimic cancer. It might cause pain, swelling, and skin changes, with anemia and elevated LDH due to chronic inflammation.
- Angiosarcoma of the Breast: A rare and aggressive malignancy of the blood vessels within the breast. It can cause pain, swelling, and skin changes, with anemia and high LDH due to tumor-related effects.