Breast metastases from extramammary malignancies: multimodality imaging aspects

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Breast metastases from extramammary cancers are uncommon but indicate a poor prognosis.
• Common primary sources include melanoma, lymphoma, ovarian, lung, neuroendocrine tumors, and sarcomas.

Purpose of the Study:

• To review the clinical and imaging features of extramammary breast metastases.
• To highlight the importance of considering secondary malignancy in breast lesion diagnosis.

Main Methods:

• Review of clinical presentations and imaging findings (mammography, ultrasound, MRI, CT, PET-CT).
• Analysis of dissemination patterns (hematogenous vs. lymphatic) and their imaging correlates.
• Comparison with primary breast carcinoma and benign breast lesions.

Main Results:

• Metastases present variably, mimicking primary breast lesions.
• Hematogenous spread often appears as circumscribed masses; lymphatic spread as edema/skin thickening.
• Metastases typically lack spiculated margins or nipple retraction, unlike primary carcinomas.

Conclusions:

• Extramammary breast metastases require a high index of suspicion in the appropriate clinical context.
• Multimodality imaging is crucial for accurate diagnosis and differentiating from primary breast disease.
• Understanding imaging features aids in correct diagnosis and therapeutic planning.