Prognosis of occult breast carcinoma presenting as isolated axillary nodal metastasis.
Axillary metastasis from an occult breast carcinoma is an uncommon presentation and presents a therapeutic dilemma. The objective of this study is to describe the presenting clinical features, management approach and treatment outcomes for occult breast carcinoma. We conducted a retrospective review of patients who presented with axillary nodal metastases from an occult breast carcinoma between 1997 and 2004 at the Roswell Park Cancer Institute; 2,150 patients were diagnosed and treated for breast cancer during this period. After excluding stage I and IV patients, we identified 642 who had disease metastatic to lymph nodes, 10 of these had no primary tumor in the breast despite a thorough evaluation including bilateral mammography and breast ultrasound. Of these, 7 had undergone breast magnetic resonance imaging as well. All patients underwent axillary nodal dissection. The breast was managed with radiotherapy alone in 8 patients, wide local excision with radiation therapy in 1 patient and 1 patient underwent mastectomy. No patient had a recurrence with a median 57 months of follow-up. Breast conservation with radiation therapy alone can be considered as a management option for women with occult breast cancer presenting with axillary nodal metastasis.
Varadarajan
Ramya
R
Department of Medicine, Roswell Park Cancer Institute, State University of New York at Buffalo, Buffalo, NY 14263, USA.
Edge
Stephen B
SB
Yu
Jihnhee
J
Watroba
Nancy
N
Janarthanan
Bagi R
BR
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000473:pathology* / Q000601:surgery; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis* / Q000628:therapy; D011379:Prognosis; D011878:Radiotherapy; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary