title: [An axillary metastasis as the first sign of the breast carcinoma--a case review].
abstract: BACKGROUND
  Carcinoma of the breast is the most commonly diagnosed women cancer. Less than 1% of the patients diagnosed with breast cancer initially present with axillary metastases as their only clinical manifestation. CASUISTIC: We report case of 58 years old woman with occult breast carcinoma in which extensive axillary node metastasis was the first manifestation.
  
  
  CONCLUSIONS
  Breast cancer presenting with axillary metastases and no clinical apparent primary tumour in the breast is an uncommon form of stage II or IV of this disease. Ultrasonography, mammography, MRI and excisional biopsy are indicated for detecting occult primary tumours. The appropriate treatment of the breast after an axillary presentation of occult breast carcinoma continues to be a controversial issue. Complete axillary lymph node dissection is indicated in all patients. As a local treatment of the breast is indicated irradiation of the breast or total mastectomy or subcutaneus mastectomy with application of the breast prothesis.
  
  
  CONCLUSIONS
  Axillary metastasis is rare first sign of breast cancer. Diagnostics of the occult breast carcinoma is difficult. The treatment of occult breast carcinoma is still controversial.
authors.affiliation: Ustav zdravotnických studií Univerzity Pardubice.
authors.forename: V
authors.initials: V
authors.lastname: Cervinka
authors.forename: K
authors.initials: K
authors.lastname: St'astný
authors.forename: K
authors.initials: K
authors.lastname: Havlícek
authors.forename: L
authors.initials: L
authors.lastname: Nechvátal
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental; D008875:Middle Aged