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Clinical experience with axillary presentation breast cancer
Viviana Galimberti1, Gulliermo Bassani, Simonetta Monti
1Department of Senology, European Institute of Oncology, Milan, Italy. viviana.galimberti@ieo.it
Breast Cancer Research and Treatment
|November 13, 2004
Summary
Occult breast cancer presenting as axillary metastases requires thorough investigation. While breast imaging is crucial, it often doesn't reveal the primary tumor in these cases.
Area of Science:
- Oncology
- Radiology
- Surgical Pathology
Background:
- Occult primary tumors presenting as axillary metastases pose diagnostic challenges.
- Adenocarcinoma compatible with mammary carcinoma is a common histological finding in these cases.
Purpose of the Study:
- To present the experience of managing 50 cases of occult primary breast tumors presenting as axillary metastases.
- To evaluate the effectiveness of diagnostic work-up and treatment strategies.
- To propose guidelines for the management of such patients.
Main Methods:
- Retrospective review of 50 patients with axillary metastases and adenocarcinoma of mammary carcinoma origin.
- Utilized bilateral ultrasound, mammography, MRI, and mammoscintigraphy for breast evaluation.
- Treatment included quadrantectomy, axillary dissection, radiotherapy, chemotherapy, and hormone therapy based on findings.
Main Results:
- Breast cancer was confirmed in 12 out of 23 suspected cases (24%) after initial imaging.
- The majority of patients (27) had no clinical or instrumental suspicion of breast cancer.
- At a mean follow-up of 41.3 months, 84% of patients were alive with no evidence of disease.
Conclusions:
- Extensive breast investigation is necessary for axillary metastases of suspected breast origin.
- However, routine, extensive investigations are not always revealing for the primary breast tumor.
- Guidelines are proposed for the systematic work-up of patients with axillary disease to optimize diagnosis and treatment.