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
Peau d'orange in carcinoma breast is due to: 
Select and explain. 
A. Obstruction of sub-dermal lymphatics, B. Infiltration of Cooper's ligament, C. Hematogenous dissemination, D. Hematogenous dissemination
A: Obstruction of sub-dermal lymphatics
Answer: A: Obstruction of sub-dermal lymphatics 
Explanation: Ans: A. Obstruction of sub-dermal lymphaticsPeau-d-orange is due to cutaneous lymphatic edema.Caused by obstruction of subdermal lymphatics. As the disease advances locally there may be skin involvement with peau d'orange or frank ulceration and fixation to the chest wall. This is described as cancer-en-cuirasse when the disease progresses around the chest wall.