ABSTRACT: Metastatic disease in the breast
Breast cancer is the commonest malignancy in women. However, metastatic
involvement of the breast is relatively rare. Metastatic disease
of the breast is therefore often an unexpected diagnosis in a
female patient presenting with a breast mass.
The commonest cause
is spread from a contralateral breast carcinoma. Of solid tumors
at other sites, the most common cancers to metastasize to the
breast are, in declining order of frequency, malignant melanoma,
lymphoma, lung cancer, ovarian carcinoma, soft tissue sarcoma,
and gastrointestinal and genitourinary tumors.
metastases from osteosarcoma, thyroid neoplasms, and cervical,
vaginal and endometrial carcinomas to the breast have been sporadically
reported in the literature. A clinical presentation with pain,
tenderness and discharge is distinctly unusual.
A solitary lesion
is the most common clinical presentation. Lesions that metastasize
to the breast may produce changes that look similar to those
of primary breast cancer on mammography, but they are more likely
to be multiple, are frequently bilateral, and form a nidus of
tumor cells that are usually round with fairly well-defined margins.
Microcalcifications are not a distinguishing feature, and although
their margins may be ill defined, spiculations are not commonly
found. Diagnosis is generally achieved by means of fine-needle
aspiration cytology or open biopsy of the breast masses.
reports, particular importance has been attached to the performance
of fine-needle aspiration cytology diagnosis, to differentiate
a metastasis from a second primary tumor, thus making it possible
to avoid unnecessary mastectomy and ensure that appropriate chemotherapy
and radiotherapy are implemented.
[11/28/2002; The Breast]
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