A fungating breast tumor is a rare, advanced type of cancer that causes ulcers 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.

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A fungating or ulcerating tumor can occur with several types of cancer, including breast cancer and melanoma. Nearly 2–5% 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.

Research indicates that, in most cases, 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 study from 2018 counters the notion that fungating breast tumors are exclusively from more advanced tumors.

The researchers note that small tumors can also cause ulcerations on the skin. Though they 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 a variety of symptoms, in addition to any symptoms the underlying cancer may cause.

Some common symptoms of ulcerating tumors include:

  • bad odor
  • leaking or oozing
  • itchiness
  • pain
  • warm skin (when infected)

The direct cause of ulceration is that the breast tumor grows to a point where it breaks through the skin. Though the tumor can be relatively small, it happens more often with larger tumors.

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 cancers relatively close to the skin.

Early detection of a tumor can be helpful. This can eliminate the complication of the tumor becoming fungating in the first place.

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

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

Wound care: Preventing leaking and bleeding

Caring for the ulcers or wounds can help prevent leakage, bleeding, and some pain. Though studies point to the importance of wound care, most of these studies are not large or comprehensive.

A person should follow their doctor’s recommendations on when to change their dressing and what to use to wrap their wound.

In some cases, 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. When they change the dressing, 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. There are a few ways to potentially control an odor, including:

  • 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-smelling 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 of time.

Itching

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

Keeping the dressings in place

Bandages may not always be in a good location. A person may also find it difficult to find the right size and shape dressings to use.

A person can ask their doctor for recommendations as well samples to try in order to find the best fitting dressing. Doctors may also refer people to:

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

It is not always possible to prevent a fungating tumor from occurring. 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.

However, even small tumors can cause ulceration. A person should consider getting regular screenings and talking with their doctor about any unusual lumps.

People with breasts should talk with their doctor 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.

Most sources recommend screening once every 1–2 years starting at age 40 for higher risk people and age 50 for average risk people. However, a person should speak with their doctor about their individualized risk and work with them to create an individual breast cancer screening plan.

A person should also talk with their doctor if they discover a lump or other abnormalities on their breast. A doctor can then help diagnose and treat the person as needed.

People living with fungating breast cancer or other types of breast cancer are not alone. People living with the condition may feel embarrassed, scared, or stressed.

In some cases, reaching out to and joining a support group may be helpful. Support groups come in a variety of types and styles, ranging from in-person meetings to phone or web-based groups.

A person’s family can also find support groups to help them cope.

Some potential resources include:

Fungating or ulcerating breast tumors cause lesions or 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 a bad odor. Treatment often focuses on reducing the size of the tumor as well as reducing symptom severity.