Occult primary adenocarcinoma with axillary metastases

Kemeny, Margaret; Rivera, David E.; Terz, José J.; Benfield, John R.

doi:10.1016/0002-9610(86)90135-2

Cited by 69 publications

(30 citation statements)

References 6 publications

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“…On the contrary, Svastics et al [19] and Jackson et al [22] argued that patients with CUPAx fared worse that matched patients with stage II breast cancer. Regarding clinicopathologic prognosticators nodal burden was recognized as the sole factor of prognostic significance [12,15,18,19,21,24], with patients with N1 disease (1-3 involved axillary lymph nodes) experiencing better locoregional disease control, fewer distant failures as well as superior overall survival when compared to patients with N2-3 disease. Other parameters with reported favourable prognostic or predictive significance were performance of axillary nodal dissection and absence of gross disease after surgery [17], local treatment of the ipsilateral breast by means of mastectomy or irradiation [23,24,26,28].…”

Section: Adjuvant Systemic Therapymentioning

confidence: 99%

Axillary nodal metastases from carcinoma of unknown primary (CUPAx): a systematic review of published evidence

Pentheroudakis

Lazaridis

Pavlidis

2009

Breast Cancer Res Treat

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Axillary lymph node metastases from adenocarcinoma or poorly differentiated carcinoma of unknown primary (CUPAx) represent a rare clinical entity without consensus on its biology, management and outcome. We systematically reviewed published CUPAx series and identified 24 retrospective studies enrolling 689 patients from 1975 till 2006. CUPAx affected women at a mean age of 52 years, 66% of whom post-menopausal harbouring low-volume (N1, 48%) or high-volume (52%) nodal disease from ductal adenocarcinoma (83%). Among a total of 446 patients managed with mastectomy, a small breast primary was identified histologically in 321 (72% of cases). Hormone receptor protein expression was observed in 40-50% of cases, while HER2 overexpression in 31%. CUPAx patients were managed with axillary lymph node dissection coupled to mastectomy (59%), primary breast irradiation (26%) or observation (15%). Observation was associated with high locoregional relapse rates (42%) and risk of metastatic spread. Mastectomy or radiotherapy provided locoregional disease control in 75-85% of cases, while adjuvant systemic therapy was associated with a nonsignificant trend for improved survival in few series. Five-year survival ranged from 59.4 to 88% at a median follow-up of 62 months (mean 5-year survival 72%), with axillary tumour burden being the pivotal prognostic factor. CUPAx is associated with similar presentation, biology and outcome to resected node-positive overt breast cancer and should be treated accordingly.

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Section: Adjuvant Systemic Therapymentioning

confidence: 99%

Axillary nodal metastases from carcinoma of unknown primary (CUPAx): a systematic review of published evidence

Pentheroudakis

Lazaridis

Pavlidis

2009

Breast Cancer Res Treat

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“…An age over 50 is the main risk factor for breast cancer. The practical consequence is the age at which mass screening is done in these countries; 50 to 74 years [12][13][14]. But in Africa, according to epidemiological data, breast cancer occurs at early ages as it's the case in our study where most breast cancer patients were between 30 and 40 years of age [2][3][4].…”

Section: Socio-demographic Characteristicsmentioning

confidence: 94%

Epidemiology and Management of Gynecological and Breast Cancers in the Two Reference Hospitals of Parakou, in North Benin

Aaa¹,

Mv²,

Brun³

et al. 2017

Oncology and cancer case reports

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“…Memeye sadece RT uygulandığı üçüncü seçenekte mastektomiye benzer sonuçlar açıklanmaktadır (6,8,(70)(71)(72)(73) …”

Section: Memeunclassified

Occult Breast Cancer

Kebudi¹

2013

J Breasth Health

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Breast carcinoma is the most common malignancy in women after skin cancer and, after lung cancer, the most frequent cause of cancer death in females. With advances in screening over the past 25 years, fewer than 10% of patients will present with metastatic breast carcinoma at the time of diagnosis. Occult breast carcinoma presenting axillary metastases is uncommon and accounts for less than 1% of newly diagnosed breast carcinoma. However, it continues to be a challenging diagnostic and therapeutic problem. In this review, the current approach to diagnosis and treatment of occult breast cancer is discussed. Okult primer meme kanserleri (OMK), T0N1 (evre II) olarak sınıf-landırılmaktadır. Aksiller metastazı olan OMK insidansı düşük-tür. Mamografi öncesi döneme ait üç geniş seride, bu oran tüm meme kanserleri içinde %0,30-1 (2-4) iken, mamografi dönemin-de dört geniş seride bu oran %0,34-0,88 olarak bulunmuştur (5-8) (Tablo 1).Mamografi, ultrasonografi (US) ve Manyetik Rezonanstaki (MR) gelişmelerle birlikte aksiller metastazlı OMK tanısında azalma söz konusudur. Curie Enstitüsü'nde 1960-1997 yılları arasında 59 hasta tedavi edilmiştir (9). Hastalarda medyan yaş 57 (36-79) idi. Otuz beş hasta (%58) postmenopozal dönemde ve iki hasta hormon replasman tedavisi görmekteydi. On beş hastada (%25) meme kanseri aile öyküsü saptandı. Ayrıca diğer çalışmalarda da, bu hasta grubunda ailesel meme kanseri öyküsü yüksek oranda bulunmuştur (6-8). Yirmi sekiz hastada (%47,5) sol aksiller nodlar ve 31 hastada da (%52,5) sağ aksiller nodlar ön plandaydı. TanıKlinik Muayene: OMK tanılı kadınların yaş ortalaması 45-55 arasıdır (10). Lenf nodlarının ortalama çapını Haagensen ve ekibi (11) ile Andrade ve ekibi (12) 4,7 cm, Curie Enstitüsü ise 3 cm olarak vermiştir (13). Nadiren, karşı memede kanser hikayesi olan hastalarda aksiller metastaz görülebilir (14,15). Bu durumda aksilladaki tutulumun nedeninin karşı taraftaki meme kanserinden mi, yoksa aynı taraftaki memedeki yeni, okult bir kanserden mi olduğunu söylemek zordur.Büyümüş aksiller lenf nodları genellikle selimdir, %70 oranında nonspesifik inflamatuvar veya hiperplastik değişikliklere bağlı, %7 oranında da granülomlara bağlı olarak gelişmektedir (16,17). Geriye kalan olgularda malign bir neden vardır. Kadınlarda en sık primer kanser, memenin adenokarsinomudur. Lenfoma ve metastatik kanserler de diğer sebeplerdir. Cilt melanomu, tiroid, akciğer, over, gastrointestinal ve böbrek hücreli kanserler, prostat kanseri meme bölgesine metastaz yapan kanserler olarak sayılabilir (18)(19)(20).Aksiller adenopatisi olan bir kadında tanı amacıyla yapılacak ilk iş, dikkatli bir anamnez alma ve iyi bir fizik muayenedir. Örneğin diğer lenf nodu bulunan bölgelerde yaygın lenfadenopati viral etyoloji

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Occult primary adenocarcinoma with axillary metastases

Cited by 69 publications

References 6 publications

Axillary nodal metastases from carcinoma of unknown primary (CUPAx): a systematic review of published evidence

Axillary nodal metastases from carcinoma of unknown primary (CUPAx): a systematic review of published evidence

Epidemiology and Management of Gynecological and Breast Cancers in the Two Reference Hospitals of Parakou, in North Benin

Occult Breast Cancer

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