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Occult breast cancer and axillary mass

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Opinion statement

Occult breast cancer presenting with axillary metastases is an unusual presentation and can be a diagnostic and therapeutic challenge. A comprehensive work-up, including mammogram, sonogram, magnetic resonance imaging, and even pathologic examination of the mastectomy specimen may not disclose the primary tumor in up to one third of patients. Traditionally, occult breast cancer is treated with total mastectomy and axillary dissection, but accumulating data suggest that primary breast irradiation following axillary dissection may provide an equivalent survival with the advantage of breast conservation. Occult breast cancer patients are eligible for adjuvant chemotherapy and radiation as stage II/III node-positive patients would be treated. Overall, the prognosis for occult breast cancer is equivalent to or slightly better than staged counterparts with detectable primary breast tumors.

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References and Recommended Reading

  1. Kemeny MM, Rivera De, Terz JJ, Benfield JR: Occult primary adenocarcinoma with axillary metastases. Am J Surg 1986, 152:43–47.

    Article  PubMed  CAS  Google Scholar 

  2. Fourquet A, de la Rochefordiere A, Campana F: Occult primary cancer with metastases. In Diseases of the Breast. Harris JR, Lippman ME, Morrow M, et al., eds. Philadelphia: Lippincott Raven; 1996:892–896.

    Google Scholar 

  3. Baron PL, Moore MP, Kinne DW, et al.: Occult breast cancer presenting with axillary metastases: Updated management. Arch Surg 1990, 125:210.

    PubMed  CAS  Google Scholar 

  4. Halsted W: The results of radical operations for the cure of carcinoma of the breast. Ann Surg 1907, 46:1.

    Article  PubMed  CAS  Google Scholar 

  5. Cameron HC: Some clinical facts regarding mammary cancer. Br Med J 1909, 1:577–582.

    Article  PubMed  Google Scholar 

  6. Haupt HM, Rosen PP, Kinne DW: Breast carcinoma presenting with axillary lymph node metastases. Am J Surg Pathol 1985, 9:165–175.

    Article  PubMed  CAS  Google Scholar 

  7. Ellerbroek N, Holmes F, Singletary E, et al.: Treatment of patients with isolated axillary nodal metastases in an occult primary carcinoma consistent with breast origin. Cancer 1990, 66:1461–1467.

    Article  PubMed  CAS  Google Scholar 

  8. Merson M, Andreola S, Galmiberti V, et al.: Breast carcinoma presenting as axillary metastases without evidence of a primary tumor. Cancer 1992, 70:504–508.

    Article  PubMed  CAS  Google Scholar 

  9. Morris EA, Schwartz LH, Dershaw DD, et al.: MR imaging of the breast in patients with occult primary breast carcinoma. Radiology 1997, 205:437–440.

    PubMed  CAS  Google Scholar 

  10. Obdeijn IM, Brouwers-Kuyper EM, Tilanus-Linthorst MM, et al.: MR imaging-guided sonography followed by fine-needle aspiration cytology in occult carcinoma of the breast. AJR Am J Roentgenol 2000, 174:1079–1084.

    PubMed  CAS  Google Scholar 

  11. Orel SG, Weinstein SP, Schnall MD, et al.: Breast MR imaging in patients with axillary node metastases and unknown primary malignancy. Radiology 1999, 212:543–549.

    PubMed  CAS  Google Scholar 

  12. Wei-Jei L, Jan-Show C, Kai-Mo C: Occult breast carcinoma—use of color Doppler in localization. Br C Res Treat 1996, 37:299–302.

    Article  Google Scholar 

  13. Avril N, Dose J, Janicke F, et al.: Assessment of axillary lymph node involvement in breast cancer patients with positron emission tomography using radiolabeled 2-(fluorine-18)-flouro-2-deoxy-D-glucose. J Natl Cancer Inst 1996, 88:1204–1209.

    Article  PubMed  CAS  Google Scholar 

  14. Rosen PP, Kimmel M: Occult breast carcinoma presenting with axillary lymph node metastases: a follow-up study of 48 patients. Hum Pathol 1990, 21:518–523.

    Article  PubMed  CAS  Google Scholar 

  15. Patel J, Takuma N, Dutau R, et al.: Axillary lymph node metastasis from an occult breast cancer. Cancer 1981, 47:2923–2927.

    Article  PubMed  CAS  Google Scholar 

  16. Vilcoq JR, Calle R, Ferme F, Veith F: Conservative treatment of axillary adenopathy due to probable subclinical breast cancer. Arch Surg 1982, 117:1136–1138.

    PubMed  CAS  Google Scholar 

  17. Goldhirsch A, Glick JH, Gelber RD, Senn H-J: Meeting highlights: international consensus panel on the treatment of primary breast cancer. J Natl Cancer Inst 1998, 90:1601–1608.

    Article  PubMed  CAS  Google Scholar 

  18. Fisher B, Constantino JP, Wickerham DL, et al.:Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst 2000, 92:943–944.

    Article  Google Scholar 

  19. Fowble B, Gray R, Gilchrist K, et al.: Identification of a subgroup of patients with breast cancer and histologically positive axillary nodes receiving adjuvant chemotherapy who may benefit from postoperative radiotherapy. J Clin Oncol 1988, 6:1107–1117.

    PubMed  CAS  Google Scholar 

  20. FowbleB: Postmastectomy radiation: a modest benefit prevails for high risk patients. Cancer 1997, 79:1061–1066. One of the few studies reporting an improvement in relapsefree survival.

    Article  PubMed  CAS  Google Scholar 

  21. Schnabel FR, Estabrook A. Surgical treatment of patients at high risk of cancer, and with unusual neoplasms and clinical presentations. In Breast Cancer. Edited by Roses DF. Churchill Livingstone; 1999:579–591.

  22. Early Breast Cancer Trialsts’ Collaborative Group: Polychemotherapy for early breast cancer: an overview of the randomized trials. Lancet 1998, 352:930–942.

    Article  Google Scholar 

  23. Miles D: Breast cancer tumour vaccines. Cancer Treat Rev 1997, 1:S77-S85.

    Article  Google Scholar 

  24. Whillis D, Brown PW, Rodger A: Adenocarcinoma from an unknown primary presenting in women with an axillary mass. Clin Oncol 1990, 2:189–1992.

    Article  CAS  Google Scholar 

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Brill, K.L., Brenin, D.R. Occult breast cancer and axillary mass. Curr. Treat. Options in Oncol. 2, 149–155 (2001). https://doi.org/10.1007/s11864-001-0057-x

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