Table of ContentsView AllTable of ContentsAppearance and LocationFungating Tumor CarePrimary and SecondaryEffect on PrognosisFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Appearance and Location
Fungating Tumor Care
Primary and Secondary
Effect on Prognosis
Frequently Asked Questions
Afungating, or ulcerating,breast canceris one in which the cancerous tissue breaks through the skin of the breast. This skin can start bleeding or weeping fluid, and the tumor can cause the skin to die (turnnecrotic) and get infected, resulting in a foul smell and an open wound.
Fungating tumors are rare but can occur in breast and skin cancers. They may also develop due to specific radiation treatments.
Large fungating tumors usually develop in people with advanced cancers that have spread (aremetastatic) and in people not getting treatment for the tumor.But it’s not always a sign of advanced cancer. If you have an ulcerating wound, talk with a healthcare provider to get a clear diagnosis.
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Fungating tumors are relatively rare. Out of the 1 million global cases of breast cancer yearly, 10% to 30% are locally advanced. Only 2% to 5% of locally advanced breast cancers develop a fungating wound.Locally advanced cancers have spread to surrounding tissues and potentially to regionallymph nodes.
This article will describe fungating breast cancers, how to manage and care for the wound, and how life expectancy differs in this type of breast cancer from other types of breast cancer.
The ulcer looks like an open wound. It may bleed, weep, or crust over. It may develop a growth shaped like a fungus, mushroom, or cauliflower.
The common symptoms of a fungating tumor include:
The most common location for these fungating tumors is the skin of the:
If the fungating tumor can’t be removed surgically, it can be very hard to heal completely.Generally, treatment for fungating tumors involves:
Wound CareTo care for a fungating tumor, you’ll need wound-care tools, including suitable bandages, adhesive tape or a wrap to keep the bandages in place, and sterile saline to clean the wound. Antibiotic or pain-relieving ointment may also help. Barrier creams can save healthy skin from damage from bandages or adhesives.
Wound Care
To care for a fungating tumor, you’ll need wound-care tools, including suitable bandages, adhesive tape or a wrap to keep the bandages in place, and sterile saline to clean the wound. Antibiotic or pain-relieving ointment may also help. Barrier creams can save healthy skin from damage from bandages or adhesives.
These days, wound dressings are not limited to big adhesive bandages. Dressings that are good for wounds with a lot of fluid include:
Wounds that have become odorous might benefit from dressings with:
Other specialized dressings include:
A wound-care specialist (potentially a physician, plastic surgeon, or nurse) can help keep the wound clean and advise you on how to care for it. Your care team can tell you which dressings to use based on the size and location of your wound.
They may have you come back in for dressing changes or have you change the dressings at home. A home-care nurse may also be able to help with dressing changes. Specialized dressings can be expensive, especially if dressing changes are needed often.
During a dressing change, you or your healthcare provider should:
If there is bleeding, ensure it stops within 15 minutes before applying the new dressing. Strategies for stopping bleeding include:
If the bleeding doesn’t stop, see your healthcare provider.
Physical Coping Strategies
Even with the best wound care, ulcerating wounds can be very uncomfortable. They may be painful, have a foul odor, or weep a lot of fluid. They may grow many times larger than normal, causing asymmetry. There are several options to manage many of these issues.
Special surgical dressings, like those made with charcoal, can help reduce the odor of an infected wound and also make it more comfortable to wear clothing or move around. Antibiotics can also help.
If the tumor leaking fluid is seeping through your clothes, consider adding a layer of non-sterile, absorbent dressings over your wound.
If changing the dressings is painful, ask your healthcare provider about painkiller options.
Mental Health
A fungating wound is a visible and sometimes painful reminder of cancer. A large wound that doesn’t heal, smells foul, or leaks can be distressing. Fungating or ulcerating tumors can be tougher on your mental health than advanced cancer on its own. Being unable to fix or heal the wound can be traumatic—as if you have lost control of your body.
People with fungating wounds may feel embarrassment, shame, anger, anxiety, or guilt. Clinical depression is common in these people.
It can be even worse if the wound is visible to others. They may notice the smell, swelling, or leaking fluid, making you feel your illness is on display. You may start to avoid social situations or become withdrawn.
Caregiver Advice
Talk to your treatment team about discussing your feelings with a mental health professional. Your healthcare providers can help you process these changes in your body.
Help With Dressing Changes
Changing your dressings frequently can damage the healthy skin around the tumor. You may find that barrier products help protect the skin. These can be sprayed or painted on surrounding healthy skin to keep the bandages from damaging it.
You may also ask your healthcare provider about adding an ostomy barrier, which can be applied to theskin around the woundthat acts as a second skin barrier. These must be changed weekly but can protect the skin without further damaging it.
You can ask your healthcare provider for pain relief options to help with the dressing change; they may suggest using a local painkiller gel or cream.
Primary and Secondary Formation
Fungating tumors can be either primary or secondary. Primary ulcerating wounds develop from the first tumor that becomes cancer. These are most commonly seen in skin cancers but can also develop in other cancers.
Secondary fungating breast cancer spreads to the breast once the tumor becomes malignant. Cancer can start in the breast or another body part, but the tumor that leads to an ulcerating or fungating wound is not the first tumor that developed.
Fungating breast cancer is usually associated with advanced disease, as an ulcerating wound can signify a very large breast tumor. Although it’s been reported in medical literature that the life expectancy of a person with breast cancer with a fungating mass is limited to six to 12 months, many people with smaller tumors often live longer.
In a 2017 study, people with breast cancer who had skin ulceration at diagnosis were matched with people with breast cancer without ulcers. The two groups showed minimal differences in survival rates, as follows:
The study shows that skin ulceration doesn’t seem to make much difference in survival rate if the cancer is treatable. But, the study excluded people with more advanced cancers, including those larger than 5-centimeter, inoperable tumors that extended into the chest wall.
It’s possible that these more advanced cancers may lead to extended fungating tumors because they can’t be removed.
Summary
Fungating breast cancer is when a tumor breaks through the skin. This skin can start bleeding or weeping fluid, and cancer can cause the skin to die and get infected, resulting in a foul smell and an open wound.
Healthcare providers and wound-care nurses treat fungating breast cancers in many ways. But the most essential treatment is quality wound care. A wound-care nurse or physician can help you assess the wound, ensure you’re using the best dressings for the wound, and show you how to care for it.
Fungating wounds are often associated with locally advanced cancer that is very large or has spread within the chest. Often they are due to cancers that are not surgically removable or that are not being adequately treated.
There’s uncertainty regarding how the presence of an ulcerating wound impacts breast cancer prognosis, especially if the tumor is smaller or surgically removable.
A Word From Verywell
An ulcerating or fungating wound associated with breast cancer can be a huge stressor. Your body may not feel like your own, and you may feel anxious or depressed about your illness. Ask about talking to a mental health expert to deal with the feelings the wound brings up.
Talk to your healthcare team about the best ways to deal with the symptoms of a fungating tumor, especially the smell and the pain. A fungating tumor doesn’t always mean a dire prognosis. Your healthcare provider will help you care for the wound, manage symptoms, and discuss a prognosis with you.
Frequently Asked QuestionsIt can be hard to fully heal a fungating wound. Surgery to remove the breast may be an option for a fungating breast cancer tumor, but advanced cancer may be too large or may have spread too far to remove safely (e.g., into the chest wall). In these cases, radiation and systemic cancer treatments can help shrink the tumor and reduce the size of the wound.Learn MoreBreast Cancer TreatmentThere are a few things that can help with odor from fungating breast tumors:Cleaning the wound regularlyChanging the dressingsUsing charcoal dressings or additional non-sterile dressingsAntibiotics to fight the infectionEnzymatic solutions or ointments to help break down dead tissueHaving a wound care specialist remove dead tissue from the woundKeeping the wound moist to ensure the body can break down dead tissueSurgery to remove the tumor and woundMedical maggots to remove dead tissueYou can also try to disguise the wound’s smell with air fresheners, odor neutralizers, environmental air filters, and aromatherapy oils in the room or on your person (not on the wound). These are also useful during dressing changes if you find the smell of the wound distressing.Learn MoreTypes of Debridement of a WoundSpecialists that treat fungating breast cancer include a:Wound-care specialist (physician or nurse)SurgeonPlastic surgeonVascular surgeonto treat uncontrolled bleedingYour cancer care teamA palliative care provider (physician or nurse)Learn MoreWhat Is Palliative Care?
It can be hard to fully heal a fungating wound. Surgery to remove the breast may be an option for a fungating breast cancer tumor, but advanced cancer may be too large or may have spread too far to remove safely (e.g., into the chest wall). In these cases, radiation and systemic cancer treatments can help shrink the tumor and reduce the size of the wound.Learn MoreBreast Cancer Treatment
It can be hard to fully heal a fungating wound. Surgery to remove the breast may be an option for a fungating breast cancer tumor, but advanced cancer may be too large or may have spread too far to remove safely (e.g., into the chest wall). In these cases, radiation and systemic cancer treatments can help shrink the tumor and reduce the size of the wound.
Learn MoreBreast Cancer Treatment
There are a few things that can help with odor from fungating breast tumors:Cleaning the wound regularlyChanging the dressingsUsing charcoal dressings or additional non-sterile dressingsAntibiotics to fight the infectionEnzymatic solutions or ointments to help break down dead tissueHaving a wound care specialist remove dead tissue from the woundKeeping the wound moist to ensure the body can break down dead tissueSurgery to remove the tumor and woundMedical maggots to remove dead tissueYou can also try to disguise the wound’s smell with air fresheners, odor neutralizers, environmental air filters, and aromatherapy oils in the room or on your person (not on the wound). These are also useful during dressing changes if you find the smell of the wound distressing.Learn MoreTypes of Debridement of a Wound
There are a few things that can help with odor from fungating breast tumors:Cleaning the wound regularlyChanging the dressingsUsing charcoal dressings or additional non-sterile dressingsAntibiotics to fight the infectionEnzymatic solutions or ointments to help break down dead tissueHaving a wound care specialist remove dead tissue from the woundKeeping the wound moist to ensure the body can break down dead tissueSurgery to remove the tumor and woundMedical maggots to remove dead tissueYou can also try to disguise the wound’s smell with air fresheners, odor neutralizers, environmental air filters, and aromatherapy oils in the room or on your person (not on the wound). These are also useful during dressing changes if you find the smell of the wound distressing.
There are a few things that can help with odor from fungating breast tumors:
You can also try to disguise the wound’s smell with air fresheners, odor neutralizers, environmental air filters, and aromatherapy oils in the room or on your person (not on the wound). These are also useful during dressing changes if you find the smell of the wound distressing.
Learn MoreTypes of Debridement of a Wound
Specialists that treat fungating breast cancer include a:Wound-care specialist (physician or nurse)SurgeonPlastic surgeonVascular surgeonto treat uncontrolled bleedingYour cancer care teamA palliative care provider (physician or nurse)Learn MoreWhat Is Palliative Care?
Specialists that treat fungating breast cancer include a:Wound-care specialist (physician or nurse)SurgeonPlastic surgeonVascular surgeonto treat uncontrolled bleedingYour cancer care teamA palliative care provider (physician or nurse)
Specialists that treat fungating breast cancer include a:
Learn MoreWhat Is Palliative Care?
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cancer Institute.Definition of fungating lesion.Tower Wound Care Center.Fungating tumors specialist.Cancer Research UK.About ulcerating cancers (fungating tumours).Rupert KL, Fehl AJ.A patient-centered approach for the treatment of fungating breast wounds.J Adv Pract Oncol. 2020;11(5):503-510. doi:10.6004/jadpro.2020.11.5.6Macmillian Cancer Support.Ulcerating cancer wounds.Cancer Research UK.Looking after ulcerating tumours.Cancer Research UK.Who to talk to.Khoury T, Gaudioso C, Fang YV, et al.The role of skin ulceration in breast carcinoma staging and outcome.Breast J. 2018;24(1):41-50. doi:10.1111/tbj.12830
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cancer Institute.Definition of fungating lesion.Tower Wound Care Center.Fungating tumors specialist.Cancer Research UK.About ulcerating cancers (fungating tumours).Rupert KL, Fehl AJ.A patient-centered approach for the treatment of fungating breast wounds.J Adv Pract Oncol. 2020;11(5):503-510. doi:10.6004/jadpro.2020.11.5.6Macmillian Cancer Support.Ulcerating cancer wounds.Cancer Research UK.Looking after ulcerating tumours.Cancer Research UK.Who to talk to.Khoury T, Gaudioso C, Fang YV, et al.The role of skin ulceration in breast carcinoma staging and outcome.Breast J. 2018;24(1):41-50. doi:10.1111/tbj.12830
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Cancer Institute.Definition of fungating lesion.Tower Wound Care Center.Fungating tumors specialist.Cancer Research UK.About ulcerating cancers (fungating tumours).Rupert KL, Fehl AJ.A patient-centered approach for the treatment of fungating breast wounds.J Adv Pract Oncol. 2020;11(5):503-510. doi:10.6004/jadpro.2020.11.5.6Macmillian Cancer Support.Ulcerating cancer wounds.Cancer Research UK.Looking after ulcerating tumours.Cancer Research UK.Who to talk to.Khoury T, Gaudioso C, Fang YV, et al.The role of skin ulceration in breast carcinoma staging and outcome.Breast J. 2018;24(1):41-50. doi:10.1111/tbj.12830
National Cancer Institute.Definition of fungating lesion.
Tower Wound Care Center.Fungating tumors specialist.
Cancer Research UK.About ulcerating cancers (fungating tumours).
Rupert KL, Fehl AJ.A patient-centered approach for the treatment of fungating breast wounds.J Adv Pract Oncol. 2020;11(5):503-510. doi:10.6004/jadpro.2020.11.5.6
Macmillian Cancer Support.Ulcerating cancer wounds.
Cancer Research UK.Looking after ulcerating tumours.
Cancer Research UK.Who to talk to.
Khoury T, Gaudioso C, Fang YV, et al.The role of skin ulceration in breast carcinoma staging and outcome.Breast J. 2018;24(1):41-50. doi:10.1111/tbj.12830
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