What characteristic symptom can invasive ductal carcinoma cause in the skin?

Invasive ductal carcinoma, which is the most common type of breast cancer, can lead to specific changes in the skin over the breast, one of which is dimpling. This occurs due to the retraction or distortion of Cooper's ligaments, which are connective tissue structures that help support the breast tissue. When a tumor invades surrounding tissues, it can pull on these ligaments, leading to the noticeable dimpling or puckering of the skin.

This characteristic sign is important clinically as it can indicate the presence of a malignant process in the breast that requires further evaluation and management. Other options, such as puffiness of the nipple, fever and chills, or severe pain, are not typical signs associated with invasive ductal carcinoma specifically and do not reflect the characteristic effects on the skin that result from the involvement of underlying structures like Cooper's ligaments.