Breast metastases from extramammary malignancies: typical and atypical ultrasound features.
Breast metastases from extramammary malignancies are uncommon. The most common sources are lymphomas/leukemias and melanomas. Some of the less common sources include carcinomas of the lung, ovary, and stomach, and infrequently, carcinoid tumors, hypernephromas, carcinomas of the liver, tonsil, pleura, pancreas, cervix, perineum, endometrium and bladder. Breast metastases from extramammary malignancies have both hematogenous and lymphatic routes. According to their routes, there are common radiological features of metastatic diseases of the breast, but the features are not specific for metastases. Typical ultrasound (US) features of hematogenous metastases include single or multiple, round to oval shaped, well-circumscribed hypoechoic masses without spiculations, calcifications, or architectural distortion; these masses are commonly located superficially in subcutaneous tissue or immediately adjacent to the breast parenchyma that is relatively rich in blood supply. Typical US features of lymphatic breast metastases include diffusely and heterogeneously increased echogenicities in subcutaneous fat and glandular tissue and a thick trabecular pattern with secondary skin thickening, lymphedema, and lymph node enlargement. However, lesions show variable US features in some cases, and differentiation of these lesions from primary breast cancer or from benign lesions is difficult. In this review, we demonstrate various US appearances of breast metastases from extramammary malignancies as typical and atypical features, based on the results of US and other imaging studies performed at our institution. Awareness of the typical and atypical imaging features of these lesions may be helpful to diagnose metastatic lesions of the breast.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea. ; Department of Radiology, Catholic University of Daegu College of Medicine, Daegu 712-702, Korea.
Sung Hee
SH
Mun
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
Eun Young
EY
Ko
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
Boo-Kyung
BK
Han
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
Jung Hee
JH
Shin
Department of Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan 614-735, Korea.
Suk Jung
SJ
Kim
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
Eun Yoon
EY
Cho
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary; D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D018567:Breast Neoplasms, Male / Q000000981:diagnostic imaging / Q000556:secondary; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000556:secondary; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D054391:Lymphoma, Extranodal NK-T-Cell / Q000000981:diagnostic imaging / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000556:secondary; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging / Q000556:secondary; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D014463:Ultrasonography
Breast; Extramammary; Metastasis; Ultrasound