Occult breast carcinoma presenting with axillary lymph node metastases: report of two cases

We report two unusual cases of occult breast carcinoma in which extensive axillary node metastasis was the first manifestation. A microscopic lesion of intraductal carcinoma was found in the tissue of one resected breast and a small infiltrative ductal carcinoma, 0.8 cm in size, in the greatest dimension in the other. Extensive metastasis was found in 26 out of 51 and 10 out of 15 axillary nodes, respectively. Results of immunohistochemical stains for estrogen and progesterone receptors on fresh frozen sections were negative for metastatic nodes in one case and both were positive for primary and metastatic tumors in the other. We review the literature and discuss the diagnosis, management and prognosis in female patients presenting with metastatic carcinoma in the axillary nodes.