Understanding the Biology of Occult Breast Cancer: Examination of 31 Cases Reveals Aggressive Behavior

Hotta, Mayo; Khurana, Maya; Sung, Michael; O’Connor, Victoria

doi:10.1177/000313482008600304

Cited by 4 publications

(6 citation statements)

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“…According to previous literature and case reports, the most common sites of pathological diagnosis or metastasis were the axilla, bone, and orbit. Meanwhile, some uncommon sites had also been reported, including gastrointestinal tract, liver, lung, thyroid, and brain (8)(9)(10). OBC patients with distant metastatic disease have a much worse prognosis, with a 5-year survival of 14.3% (8).…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, some uncommon sites had also been reported, including gastrointestinal tract, liver, lung, thyroid, and brain (8)(9)(10). OBC patients with distant metastatic disease have a much worse prognosis, with a 5-year survival of 14.3% (8). Thus, it is of great significance to ascertain whether there is distant metastasis in patients of OBC.…”

Section: Discussionmentioning

confidence: 99%

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Case report: Uncommon multiple metastases from occult breast cancer revealed by 68Ga-DOTATATE PET/CT

Zhang

et al. 2023

Front. Oncol.

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Occult breast cancer is an uncommon type of breast cancer and its diagnosis is challenging. It is usually invisible on multiple imaging examines. Metastases to the rectum and inguinal lymph nodes from occult breast lobular cancer are even rarer. 68Ga-DOTA peptides can image neuroendocrine tumors by targeting specific somatostatin receptors. Besides, other tumors, including breast cancer, have been shown to express somatostatin receptors. In this case, we presented a 63-year-old woman who underwent both 18F-FDG and 68Ga-DOTATATE PET/CT due to a rectal polyp. An endoscopic excision biopsy confirmed metastatic carcinoma of suspected breast origin, but subsequent ultrasound and MRI showed no signs of malignancy in the breast and adnexa uteri. PET/CT showed obvious 68Ga-DOTATATE activity in bilateral axillary and right inguinal lymph nodes with mild 18F-FDG uptake. Final histopathology at the left axillary, right inguinal lymph nodes, and rectum indicated metastases from breast cancer while the origin remained radiologically occult. Additionally, one uterine fibroids was found with positive uptake of 68Ga-DOTATATE and negative uptake of 18F-FDG. This case suggested that 68Ga-DOTATAE PET/CT may be an effective supplement in diagnosing OBC lymph node metastases with mild 18F-FDG uptake, and it may provide a new technology for the clinical diagnosis of occult breast cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case report: Uncommon multiple metastases from occult breast cancer revealed by 68Ga-DOTATATE PET/CT

Zhang

et al. 2023

Front. Oncol.

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“…The clinical and pathological characteristics of the patients were analyzed. The most common site of pathological diagnosis/metastasis was the axilla in 23 (74.2%) patients, followed by bone in three (9.7%), orbit in two (6.5%), and one each in the liver, lung, and brain ( 6 ). Moreover, the prognosis of OBC is still debatable.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the prognosis of OBC is still debatable. Although the 10-year overall survival of OBC in different reports has varied from 45% to nearly 70% ( 7 ), OBC patients with distant metastatic disease have a much worse prognosis, with a 5-year survival of 14.3% ( 6 ). Therefore, it is crucial to ascertain if an OBC has distant metastasis or not.…”

Section: Discussionmentioning

confidence: 99%

Case report: Unique ultrasound feature of thyroid metastases in occult breast cancer

et al. 2022

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Occult breast cancer is an uncommon type of breast cancer. Metastases of occult breast cancer to other tissues are rather rare. We present a rare case of thyroid metastases in a 46-year-old woman who underwent occult breast cancer. The first ultrasound (US) examination of the thyroid showed that the left lobe was enlarged but had normal thyroid function. At first, this case was misdiagnosed as thyroiditis based on the thyroid US features. However, the cytological and histological results showed that nests of the neoplastic cells were found. Further immunohistochemistry results confirmed that these neoplasms were derived from breast tissue. Analysis using the successive US scans revealed that the sizes and echo of the thyroid repeatedly changed after the radiotherapy and chemotherapy treatment. To our knowledge, this is the first reported case of occult breast carcinoma presenting with thyroid metastases. This case can easily be misdiagnosed as thyroiditis due to the metastasis area not manifesting as regular suspicious nodules or diffused punctate calcifications.

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“…Nowadays, few data concerning the specific clinical patterns of CUPAx female patients are available in the literature. A recent manuscript reviewed patients’ characteristics, showing only a predominance of a favorable molecular receptor profile and a higher histological grade [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Axillary Nodal Metastases from Carcinoma of Unknown Primary (CUPAx): Role of Contrast-Enhanced Spectral Mammography (CESM) in Detecting Occult Breast Cancer

Costantini

Montella

Fadda

et al. 2021

JPM

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Axillary lymph node metastases of occult breast cancer (CUPAx) is an unusual condition that represents both a diagnostic and therapeutic challenge. The first steps in the diagnostic work-up of patients with CUPAx are the histological analysis of the lymph node metastasis and the execution of basic breast diagnostic imaging (mammography and ultrasound). In the case of occult breast cancer, breast Magnetic Resonance (MR) must be performed. Breast MR identifies a suspicious lesion in many patients and second-look ultrasound detects a corresponding ultrasound alteration in about half of cases, allowing the performance of a US-guided biopsy. In the case of an MR-only lesion, MR-guided biopsy is mandatory. We present a case of CUPAx in which contrast-enhanced spectral mammography (CESM) is used to help the detection of occult breast cancer and to guide stereotactic vacuum breast biopsy (VABB). CESM is a new breast imaging technique that is proving to have good performance in breast cancer detection and that is showing potential in the identification of occult breast cancer in a CUPAx setting. The use of an innovative and personalized breast imaging approach in breast cancer patients improves diagnostic possibilities and promises to become the focus in decision strategies.

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Understanding the Biology of Occult Breast Cancer: Examination of 31 Cases Reveals Aggressive Behavior

Cited by 4 publications

References 4 publications

Case report: Uncommon multiple metastases from occult breast cancer revealed by 68Ga-DOTATATE PET/CT

Case report: Uncommon multiple metastases from occult breast cancer revealed by 68Ga-DOTATATE PET/CT

Case report: Unique ultrasound feature of thyroid metastases in occult breast cancer

Axillary Nodal Metastases from Carcinoma of Unknown Primary (CUPAx): Role of Contrast-Enhanced Spectral Mammography (CESM) in Detecting Occult Breast Cancer

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