Ultrasonographic Appearance and Clinical Implication of Bilateral Breast Infiltration with Leukemia Cells

Asai, Satoshi; Miyachi, Hayato; Kubota, Mitsuhiro; Koyanagi, Noriko; Ogawa, Yoshiaki; Hotta, Tomomitsu; Andō, Yasuhiko

doi:10.1007/4-431-27008-6_30

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…Marrow remission and clinical breast response was attained in all but one. Although there were four relapses in extramedullary sites and one in bone marrow, there are three cases disease‐free for 1 to 12+ years [70–72] . Chemotherapy alone was not as successful among patients whose breast tumors occurred after a remission induced by chemotherapy; only five of the nine obtained responses, none lasting over 13 months.…”

Section: Resultsmentioning

confidence: 99%

“…There are only four cases among 106 AML and ALL patients treated with chemotherapy alone with disease‐free survivals from 4 to 12 years. They include one AML and two ALL cases who received chemotherapy for newly diagnosed marrow and breast leukemias [44, 70, 72], and the de novo case treated for WT‐1 expression in both sites[33]. With these observations, there is little data to justify relying on chemotherapy alone when extramedullary breast tumors, or probably any soft tissue leukemic tumors, are found.…”

Section: Discussionmentioning

confidence: 99%

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A basis for updating our approach to resistant acute leukemia

Cunningham

2012

American J Hematol

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No studies exist documenting that chemotherapy alone eradicates tumors composed of leukemic cells in a large group of patients with tumors at any one site. Yet, its use has continued over 40 years in the absence of data. Consensus protocols exist only for testis and meningeal tumors, relying on local therapy. To constitute a body of knowledge about tumors at one site, the breast was chosen and all published cases were analyzed, with follow-up obtained, to document the behavior of acute leukemia tumors and survival after presentation. Among 235 cases (52% published since 2000), overall survival was poor, particularly for the 43% with concurrent morphologic marrow relapse, with 66-73% one-year mortality. Only 4 of 106 patients treated with chemotherapy alone survived 4 years. The majority of AML and ALL tumors were only transiently responsive to anti-leukemia treatments, including transplant, and next relapses were as, or more, common in further tumors than in marrow. A pattern of tumors similar to the metastases of invasive lobular breast cancer was revealed. When relapse occurred in marrow, durable remission was only rarely obtained. These data suggest a potential benefit of incorporating extent of disease workup at diagnosis and relapse into prospective trials. This could yield an accurate incidence of extramedullary tumors and a means to identify occult residual disease which could lead to marrow relapse. This approach could potentially result in greater success in curing acute leukemias. Am. J. Hematol. 87:251-257, 2012. V

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A basis for updating our approach to resistant acute leukemia

Cunningham

2012

American J Hematol

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“…[ 4 ] In most described cases of AML involving breasts, the disease appeared as bilateral multiple nodules. [ 5 ] Differential diagnosis of palpable breast lesions of a patient with hematologic malignancies includes involvement of the breast, multiple fibroadenomas, and primary breast carcinoma. Treatment of leukemic or lymphoblastic breast involvement is similar to other localizations of infiltration and chemotherapy and/or radiotherapy are the main treatment options.…”

Section: Discussionmentioning

confidence: 99%

Differentiation of secondary involvement of the breast by lymphoreticular malignancy from fibroadenoma using ultrasound elastography: A report of two cases

Eren

Ertan

Ulus

2017

Indian Journal of Radiology and Imaging

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Extramedullary lymphoma infiltration of the breast by lymphoblastic lymphoma is very rare and most cases are of B-cell lineage; T-cell neoplasms represent less than 10% of all breast lymphomas. Here, we report one patient with lymphoblastic lymphoma and one patient with leukemia, who have similar lesions in breasts with different ultrasound elastography findings. Ultrasound-guided tru-cut biopsies were performed and the first lesion was confirmed as lymphoma infiltration and the second as fibroadenoma. In cases of breast mass presence in patients with a history of hematologic malignancies such as lymphoma or leukemia, breast infiltration should be kept in mind. Elastography findings can assist in the differentiation of these lesions and further investigations or biopsies can be avoided.

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“…Another study described the microscopic results of breast involvement in an acute leukemia case study of an autopsy series ( 1 ). In most described cases of acute myeloid leukemia involving breasts, the disease appeared bilaterally as multiple nodules ( 3 ). In addition, unilateral breast involvement in a case of acute myeloid leukemia could be seen as a single mass ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

“…1A, B ). An ultrasonographic evaluation revealed lobular-shaped and partly ill-defined hypoechoic masses with a 3-4 cm maximum diameter and a multi-septated nodular (mottled) appearance without acoustic changes ( 3 ) ( Fig. 1C, D ).…”

Section: Case Reportmentioning

confidence: 99%

Acute Lymphoblastic Leukemia Presented as Multiple Breast Masses

et al. 2009

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Breast metastases in cases leukemia are very rare and occur primarily in patients with acute myeloid leukemia. We report the involvement of breast metastases in a 30-year-old woman with acute T cell lymphoblastic leukemia. The patient's mammograms revealed an extremely dense pattern with ill-defined, denser mass-like lesions in both breasts. A bilateral breast ultrasonographic evaluation revealed lobular-shaped and partly ill-defined hypoechoic masses with a multi-septated nodular (mottled) appearance.

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Ultrasonographic Appearance and Clinical Implication of Bilateral Breast Infiltration with Leukemia Cells

Cited by 6 publications

References 10 publications

A basis for updating our approach to resistant acute leukemia

A basis for updating our approach to resistant acute leukemia

Differentiation of secondary involvement of the breast by lymphoreticular malignancy from fibroadenoma using ultrasound elastography: A report of two cases

Acute Lymphoblastic Leukemia Presented as Multiple Breast Masses

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