title: Metastases to the breast from nonbreast solid neoplasms: presentation and determinants of survival.
abstract: BACKGROUND
  Metastasis to the breast is rare, but it must be considered in the differential diagnosis of a breast mass. The purpose of this study was to identify clinical characteristics and outcomes associated with this entity to identify determinants of survival.
  
  
  METHODS
  Between 1983 and 1998, 169 patients were confirmed by pathology to have metastasis to the breast from nonbreast solid organ primary tumors at University of Texas M. D. Anderson Cancer Center. Medical records were retrospectively reviewed for clinicopathological characteristics. Survival was determined by Kaplan-Meier analysis.
  
  
  RESULTS
  The median age was 51 years (range, 13-85). One hundred forty-nine (88.2%) patients had a prior history of cancer. Ninety-one (53.9%) patients presented with additional systemic metastases. The most common histology identified was melanoma (65 patients, 38.5%). In most patients (77%), the diagnosis was initially made through physical examination. The median survival from the time the breast metastasis was diagnosed was 10 months (range, 0.4-192.7). On univariate analysis, a significantly better survival was observed in patients who had no evidence of other disease at the time of diagnosis (P = .0036), patients with neuroendocrine tumors (P = .023), and patients who underwent surgical resection for breast metastases (P = .0001). On multivariate analysis, patients who did not have surgery were 88% more likely to die than those who did (P < 0.001).
  
  
  CONCLUSIONS
  Expected survival with metastasis to the breast is poor, therefore, local therapy should be tailored to each individual. The association between overall survival and surgical resection of metastases to the breast should be further investigated.
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77230-1402, USA.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Williams
authors.forename: Richard A
authors.initials: RA
authors.lastname: Ehlers
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Hunt
authors.forename: Min
authors.initials: M
authors.lastname: Yi
authors.forename: Henry M
authors.initials: HM
authors.lastname: Kuerer
authors.forename: S Eva
authors.initials: SE
authors.lastname: Singletary
authors.forename: Merrick I
authors.initials: MI
authors.lastname: Ross
authors.forename: Barry W
authors.initials: BW
authors.lastname: Feig
authors.forename: W Fraser
authors.initials: WF
authors.lastname: Symmans
authors.forename: Funda
authors.initials: F
authors.lastname: Meric-Bernstam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology / Q000601:surgery; D001943:Breast Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome