Metastases to the breast: Differential diagnosis from primary breast carcinoma

Vergier, Béatrice; Trojani, M; Mascarel, Isabelle de; Coindre, Jean‐Michel; Treut, A. Le

doi:10.1002/jso.2930480208

Cited by 188 publications

(181 citation statements)

References 28 publications

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“…This finding has also been previously reported in the literature. 30 Similarly to the above, a contributing factor to these interpretations is the fact that the majority of these tumors presented as a solitary lesion in the breast and/or axilla.…”

Section: Discussionmentioning

confidence: 96%

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Non-mammary metastases to the breast and axilla: a study of 85 cases

et al. 2013

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Non-mammary metastases to the breast and axilla are rare occurrences. However, they are important diagnostic considerations as their treatment and prognosis differ significantly from primary breast cancer. Between 1990 and 2010, we identified a total of 85 patients, 72 women and 13 men, with non-mammary malignancies involving the breast, axilla, or both. The tumor types consisted of carcinoma (58%), melanoma (22%) and sarcoma (20%). Ovary was the most common site of origin for carcinoma, and metastatic high-grade ovarian serous carcinoma was most frequently misdiagnosed as a primary breast carcinoma. Melanoma was the single most common non-carcinomatous tumor type to involve the breast and/or axilla, and uterine leiomyosarcoma was the most common type of sarcoma. Most patients (77%) had other metastases at the time of diagnosis of the tumor, but in 11% the breast or axillary lesion was the first presentation. Without a clinical history, non-mammary metastases were difficult to diagnose because the majority of cases presented with a solitary nodule and lacked pathognomonic pathologic features. There were, however, certain recurrent histological findings identified, such as the often relatively well-circumscribed growth pattern of the metastatic lesion surrounded by a fibrous pseudocapsule, and the absence of an in situ carcinoma. Overall, these patients had poor survival; 96% of patients with follow-up available are dead of disease, with a median survival of 15 months after the diagnosis of the breast or axillary lesion. This finding emphasizes the need to accurately identify these tumors as metastases in order to avoid unnecessary procedures and treatments in these patients. Keywords: axilla; breast; extramammary Metastases to the breast and axilla are rare and account for approximately 2% of all mammary malignancies. 1,2 The most common metastatic lesion to involve the breast is a metastasis from a contralateral mammary cancer. 1,2 If hematologic malignancies are also excluded, the number of non-mammary metastases drops to well below 1%. 1,3 Owing to the frequency of primary breast cancers and the rarity of non-mammary tumors involving the breast, a newly discovered lesion in the breast or axilla is usually presumed to be a primary or metastatic breast carcinoma. However, the recognition of non-mammary metastases to the breast and axilla is very important, as both the treatment and prognosis differ significantly. Materials and methodsAfter obtaining approval by our Institutional Review Board, we searched the pathology database of Memorial Sloan-Kettering Cancer Center between the years 1990-2010 for patients with non-mammary metastases to the breast and axilla. Hematologic malignancies were excluded, as they are systemic diseases. The medical records and pathology slides, when available, were reviewed and the clinicopathologic characteristics were recorded. Patient age, gender, primary tumor site, the presence of other metastases, laterality, number of lesions, interval from primary tumor diagnosis to breast/ a...

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Section: Discussionmentioning

confidence: 96%

“…[25][26][27][28][29][30][31] In two different series of metastatic tumors to the breast, each reported four adolescent girls with metastatic rhabdomyosarcoma involving the breast. The alveolar subtype has been reported to occur much more commonly than embryonal, which is well known to be much more aggressive.…”

Section: Discussionmentioning

confidence: 99%

Non-mammary metastases to the breast and axilla: a study of 85 cases

et al. 2013

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“…The incidence of secondary metastasis to the breast is uncommon and rarely reported. It is represented by nearly up to 2% of all breast swelling which account for nearly 400 cases that have been reported in the literature [2]. Malignant melanoma, leukaemia and lymphoma are the most common among all malignancies that have been described metastasizing to the breast [2].…”

Section: Discussionmentioning

confidence: 99%

Breast and Axillary Lymph Nodes Metastasis five years after Radical Nephrectomy for Renal Cell Carcinoma A Case Report and Review of the Literature

Hairulfaizi¹,

Muhammad²,

Naqiyah³

et al. 2008

Libyan Journal of Medicine

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Abstract; Breast is an uncommon and rare site for metastasis. Primary and secondary tumors of the breast need to be differentiated as management is different. We present a 67 year old female patient with two breast lumps and an axillary lymph node, 5 years after nephrectomy for Renal Cell Carcinoma (RCC). Mammogram report showed a dense spiculated mass at right upper outer quadrant and a retroareolar mass associated with clustered micro calcifications. Fine Needle Cytology and trucut biopsy were inconclusive. Computer Topography (CT) abdomen did not show evidence of RCC recurrence. After discussion with the patient, she underwent mastectomy with axillary clearance and the final histopathology report was consistent with metastasis from RCC. The management of this case is discussed.Key words: Ext ammammary breast metastasis, Renal cell carcinoma, Post radical nephrectomy. r IntroductionRenal cell carcinoma, which accounts for approximately 3% of all adult cancers, has a tendency to metastasize, commonly to the lungs, bones, liver, adrenal glands and brain. Metastases to the breast from extramammary tumours are uncommon and metastatic renal cell carcinoma to the breast is extremely rare accounting for 3% of the cases [1]. We report metastases to the breast and the difficulty in diagnosis. Thus far, this is the first case reported as in most cases; the metastasis to the breast is part of systemic metastases.

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“…The younger age of women suggested that the breast is a favorite site for metastasis because of a relatively rich blood supply (Vergier et al, 1991;Shiraishi et al, 2001). On the other hand, Vergier et al (1991) also hypothesized that estrogen may promote extramammary tumorigenesis. Gastric cancer seems to be more aggressive in younger people with hormonal factors implicated.…”

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confidence: 99%