[Diagnosis and treatment of occult breast cancer: report of 23 cases].
OBJECTIVE
To explore the presenting clinical features, management approach and treatment outcomes for occult breast cancer.


METHODS
Twenty-three patients with occult breast cancer presenting with axillary nodal metastases treated in our department between 1986 and 2007 were included in this study. The clinicopathological, imaging and follow-up data of the 23 cases were retrospectively analyzed.


RESULTS
All patients were female. The mean age of diagnosis was 57.7 years with a range of 27 - 73 years. The mean follow-up was 15.70 months (range 1 - 62 months). Eight cases in 17 patients were positive by breast ultrasound, three cases in 9 patients were positive by mammography, one case in 2 patients was positive by breast MRI. 20 patients underwent modified radical mastectomy and three patients did not receive the mastectomy treatment. 16 patients had chemotherapy, four patients had radiotherapy, two patients had both chemotherapy and radiotherapy. Two patients had pulmonary metastasis, one patient had recurrence of axillary nodes, pulmonary metastasis and bone metastasis during follow-up.


CONCLUSIONS
A normal check before operation to exclude a cancer of other origin can help to diagnose occult breast cancer. The breast must be treated. Axillary nodal dissection and mastectomy, or breast conservation with radiation therapy alone can be considered as a management option.
Department of Breast Surgery, Peking Union Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Ying
Y
Zhong
Qiang
Q
Sun
Han-yuan
HY
Huang
Yi-dong
YD
Zhou
Jing-hong
JH
Guan
Feng
F
Mao
Yan
Y
Lin
Ya-li
YL
Xu
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000556:secondary; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000473:pathology / Q000601:surgery / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008327:Mammography; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary