A fungating breast tumor is a rare, advanced type of cancer that causes ulceration or infection on the skin of the breast or the surrounding area. A fungating tumor occurs when the mass breaks through the skin.

It causes an ulcer or wound to appear, which can be leaky, odorous, and painful.

The following article describes what to expect from fungating breast tumors, along with their causes, treatment, and more.

A fungating or ulcerating tumor can occur with several types of cancer, including breast cancer and melanoma. Nearly 2% to 5% of locally advanced breast cancers develop a fungating breast wound.

A fungating tumor occurs when the cancer cells penetrate the skin surrounding the breast. The penetration of cancer cells into the skin causes ulcers, a breakdown of the skin, and infections.

From primary tumors

Primary tumors develop from cancerous breast cells. When a primary tumor becomes ulcerative, it means the breast cancer cells have penetrated the skin and caused the lesions or ulcers to occur.

From secondary tumors

A secondary tumor develops from metastasized cancer cells, which have spread from a different area of the body.

Usually, ulceration of the skin occurs in larger, more advanced stages of breast cancer. This can include stages 3 or 4, with classifications based on the number of lymph nodes involved and the inflammation associated with the tumor.

However, a 2018 study counters the notion that fungating breast tumors are exclusively from more advanced tumors, noting that smaller tumors could also cause ulceration on the skin.

Though the authors suggest further study, they recommend that doctors do not stage smaller tumors as “advanced” unless absolutely necessary. This is because the smaller-sized tumors often share the characteristics of less advanced cancer.

Fungating or ulcerating tumors can cause various symptoms in addition to those the underlying cancer may cause.

Some common symptoms of ulcerating tumors include:

  • bad odor
  • leaking or oozing
  • itchiness
  • pain
  • warm skin

The direct cause of ulceration is that the breast tumor grows to a point where it breaks through the skin.

In some cases, ulceration may occur because the tumor grew uncontrolled and undetected for several months or years.

Breast cancer is one of a few types of cancer that typically cause ulcerating wounds to appear. Others can include head, neck, or skin cancers. What they have in common is that they are all relatively close to the skin.

Once a breast tumor has broken the skin, treatment focuses on:

  • treating the tumor
  • managing pain
  • caring for the wound to help prevent infection
  • psychological and social support

Wound care

Caring for the ulcers or wounds may help prevent leakage, bleeding, infection, and some pain. A person should follow their doctor’s recommendations on when to change their dressing and what to use to wrap their wound.

If a person finds it difficult to bandage the location of the tumor or find the right shape or size of dressing, they may be able to get support from:

  • wound care nurses
  • wound care clinics
  • help from home health aides for wound care

Sometimes, a person may find that using a barrier cream can help prevent leakage from irritating the skin around the wound.

A person should use care when changing their dressing, as they can accidentally cause bleeding. Some dressings are better suited for stopping bleeding, such as ones that turn into a gel when bleeding occurs.

Unpleasant smell

An unpleasant smell is a common symptom that can cause emotional distress or embarrassment. A few ways to potentially manage an odor include:

  • using a bandage or dressing that can help reduce odor
  • keeping the wound free from infection by using antibiotic ointments
  • using odor neutralizers and other fresh scents to help mask the smell

Pain

Pain can come directly from the tumor or from the bandages used to cover the wound. When it comes from the bandages, a person can try different adhesives or bandage types to see if that helps.

When the pain comes from the tumor, a doctor can recommend pain medications that are safe to take for a long period.

Itching

Itchiness is a common symptom of fungating breast tumors. Treatment for itchiness may include:

It is not always possible to prevent a fungating tumor. However, early detection and treatment of a tumor may help.

In general, the larger the tumor grows, the more likely it is to penetrate the skin and cause ulceration. Treating the tumor as early as possible may prevent it from breaking through the skin.

However, even small tumors can cause ulceration. For this reason, a person should consider getting regular breast cancer screenings.

A person should talk with a doctor as soon as possible if they discover a lump or any other unusual symptoms affecting the breast.

People who do not have any symptoms can also ask a medical professional about when to start screening for breast cancer.

There are several recommendations regarding the age at which people should first start getting mammograms and how often they should continue getting them.

Generally, people ages between 40 and 74 years with an average risk of breast cancer should get a screening every 2 years. However, a person should speak with a doctor about their individualized risk and work with them to create an individual plan.

People living with fungating breast cancer may feel embarrassed, scared, or stressed, but they are not alone.

In some cases, reaching out to and joining a support group may be helpful. Support groups come in various types and styles, ranging from in-person meetings to phone or web-based groups. There are also groups for family members.

Some potential resources include:

Below are answers to common questions about fungating breast tumors.

What is the life expectancy of a person with a fungating breast tumor?

This depends on the stage of the cancer. A 2018 study on breast carcinoma found that the probability of being disease-free after 5 years was similar for those with and without skin ulceration, at 53% and 58%, respectively.

These figures include people with all stages of breast cancer. The exact outlook will depend on the stage of the cancer and a person’s unique circumstances. A doctor can provide a more accurate outlook.

Can fungating breast cancer be removed?

This will depend on the size and location of the tumor. In some cases, a doctor may be able to remove it. Other treatments, such as chemotherapy or radiation, may be able to shrink the tumor.

What does a fungating tumor look like?

The term “fungating” comes from the appearance of the ulceration. It may look similar to fungi or a cauliflower.

Fungating or ulcerating breast tumors cause ulcers to appear on the skin on or around the breast. This occurs when the tumor penetrates the skin, and it can cause pain, itchiness, oozing, and an unpleasant odor.

Treatment focuses on reducing the size of the tumor as well as reducing symptom severity. This may include several cancer treatments, as well as supportive care to help reduce discomfort, pain, and other symptoms.