This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
An elderly female presented with 'Peau de orange appearance' of breast. What is it likely to be associated with? 
Select and explain. 
A. Drug reaction, B. Obstruction of cutaneous lymphatics, C. Post operative scarring, D. Tumour necrosis
B: Obstruction of cutaneous lymphatics
Answer: B: Obstruction of cutaneous lymphatics 
Explanation: The orange skin or 'peau d 'orange' appearance is caused by swelling and oedema of the skin due to infiltration of dermal lymphatics, except at points where the dermis is anchored by these suspensory ligaments of the breast. This fibrous reaction is responsible for the spiculate features of a cancer. It is seen in chronic abscess and advanced breast cancer. Ref: Applied Basic Science for Basic Surgical Training edited by Andrew T. Raftery, 2008, Page 489; Bailey & Love's 25th edition, Page 844