Abstract.
Bilateral invasive breast cancers were detected on MR imaging in a patient with left unilateral axillary lymphadenopathy and normal findings at physical examination, mammography, and ultrasound of both breasts. One spiculated and a second ill-defined enhancing lesion in the left breast as well as a superficial circumscribed lesion in the right breast were proven to be invasive malignancies. In patients with isolated axillary lymph nodes and occult primary malignancy, breast MRI can identify or exclude the breast as primary site, which proves the superiority and diagnostic benefit of this imaging method and also its contribution to the therapeutic approach.
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Morris EA, Schwartz LH, Dershaw DD, Van Zee KJ, Abramson AF, Liberman L (1997) MR imaging of the breast in patients with occult primary breast carcinoma. Radiology 205:437–440
Henry-Tillman RS, Harms SE, Westbrook KC, Korourian S, Klimberg VS (1999) Role of breast magnetic resonance imaging in determing breast as a source of unknown metastatic lymphadenopathy. Am J Surg 178:496–500
Orel SG, Weinstein SP, Schnall MD, Reynolds CA, Schuchter LM, Fraker DL, Solin LJ (1999) Breast MR imaging in patients with axillary node metastases and unknown primary malignancy. Radiology 212:543–549
Lloyd MS, Nash AG (2001) "Occult" breast cancer. Ann R Coll Surg Engl 83:420–424
Van Ooijen B, Bontenbal M, Henzen-Logmans SC, Koper PCM (1993) Axillary nodal metastases from an occult primary consistent with breast carcinoma. Br J Surg 80:1299–1300
Brenner RJ, Rothman BJ (1997) Detection of primary breast cancer in women with known adenocarcinoma metastatic to the axilla: use of MRI after negative clinical and mammographic examination. J Magn Reson Imaging 7:1153–1158
Knapper WH (1991) Management of occult breast cancer presenting as an axillary metastasis. Semin Surg Oncol 7:311–313
Foroudi F, Tiver KW (2000) Occult breast carcinoma presenting as axillary metastases. Int J Radiat Oncol Biol Phys 47:143–147
Jackson B, Scott-Conner C, Moulder J (1995) Axillary metastasis from occult breast carcinoma: diagnosis and management. Am Surg 61:431–434
Leibman AJ, Kossoff MB (1992) Mammography in women with axillary lymphadenopathy and normal breasts on physical examination: value in detecting occult breast carcinoma. Am J Roentgenol 159:493–495
Tilanus-Linthorst MM, Obdeijn AI, Bontenbal M, Oudkerk M (1997) MRI in patients with axillary metastases of occult breast carcinoma. Breast Cancer Res Treat 44:179–182
Cisneros-Reig I, Laguna Sastre M, Alcalde Sanchez M, Nomdedeu Guinot J, Gamon Giner RL, Salvador-Sanchis JL, Rodriguez Pereira C (2001) Bilateral occult breast carcinoma: a second primary tumour or contralateral tumour metastasis? Eur J Surg 167:312–315
Obdeijn I-M, Brouwers-Kuyper EM, Tilanus-Linthorst MM, Wiggers T, Oudkerk M (2000) MR imaging-guided sonography followed by fine needle aspiration cytology in occult carcinoma of the breast. Am J Roentgenol 174:1079-1084
Van de Weijer GHFM, Van Ooijen B, Hesp WLEM, Blom WF (1995) Expectatief beleid ten aanzien van de mamma bij 5 patiënten met occult mammacarcinoom. Ned Tijdschr Geneeskd 139:1648–1650
Patel J, Nemoto T, Rosner D, Dao TL, Pickren JW (1981) Axillary lymph node metastasis from an occult breast cancer. Cancer 47:2923–2927
Merson M, Andreola S, Galimberti V, Bufalino R, Marchini S, Veronesi U (1992) Breast carcinoma presenting as axillary metastases without evidence of a primary tumour. Cancer 70:504–508
Scoggins CR, Vitola JV, Sandler MP, Atkinson JB, Frexes-Steed M (1999) Occult breast carcinoma presenting as an axillary mass. Am Surg 65:1–5
Davis PL, Julian TB, Staiger M, Harris KB, Borochovitz D, Klementaviciene J, McCarty KS (1994) Magnetic resonance imaging detection and wire localization of an occult breast cancer. Breast Cancer Res Treat 32:327–330
Rieber A, Merkle E, Bohm W, Brambs HJ, Tomczak R (1997) MRI of histologically confirmed mammary carcinoma: clinical relevance of diagnostic procedures for detection of multifocal or contralateral secondary carcinoma. J Comput Assist Tomogr 21:773–779
Schwartz GF, Patesfsky AS, Feig SA, Shaber GS, Schwartz AB (1980) Multicentricity of nonpalpable breast cancer. Cancer 45:2913–2916
Feigenberg Z, Zer M, Dintsman M (1976) Axillary metastases from an unknown primary source. Isr J Med Sci 12:1153–1158
Svastics E, Ronay P, Bode M (1993) Occult breast cancer presenting with axillary metastasis. Eur J Surg Oncol 19 (Suppl 1):575–580
Kemeny MM, Rivera DE, Terz JJ, Benefield JR (1986) Occult primary adenocarcinoma with axillary metastases. Am J Surg 152:43–47
Porter BA, Smith JP, Borrow JW (1995) MR detection of occult breast cancer in patients with malignant axillary adenopathy [abstract]. Radiology 197:130
Olson JA, Morris EA, Van Zee KJ, Linehan DC, Borgen PI (2000) Magnetic resonance imaging facilitates breast conservation for occult breast cancer. Ann Surg Oncol 7:411–415
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Schelfout, K., Kersschot, E., Van Goethem, M. et al. Breast MR imaging in a patient with unilateral axillary lymphadenopathy and unknown primary malignancy. Eur Radiol 13, 2128–2132 (2003). https://doi.org/10.1007/s00330-002-1674-x
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DOI: https://doi.org/10.1007/s00330-002-1674-x