The patient's vital signs were stable, and she was initially afebrile. Physical examination revealed a markedly enlarged, tender, and indurated right breast. Bilaterally there were firm, mobile palpable breast nodules with no axillary adenopathy. She had been treated by her internist as an outpatient with multiple courses of oral antibiotics with no improvement. Computed tomography of the chest had been performed 1 week earlier, and a representative image is shown in Figure 1.