Clinical experience with axillary presentation breast cancer

Abstract

We present our experience of 50 cases of occult primary tumours presenting as axillary metastases, all with histological report of adenocarcinoma compatible with mammary carcinoma. After bilateral US and mammography, with MRI and mammoscintigraphy where necessary, ipsilateral breast cancer was suspected in 23 cases and quadrantectomy performed. Breast cancer was found only in 12 (24%). In the other 27 women there was no clinical or instrumental suspicion of breast cancer or other primary disease site, so the main treatment was complete axillary dissection plus radiotherapy to the ipsilateral breast (given to all patients). Chemotherapy alone was given to 27 patients, hormone treatment to 5 patients, and both to 18. Mean follow-up is 41.3 months (range 108-1). Thirty-nine (84%) patients are alive with no evidence of disease, two are alive with breast disease, five patients have died of metastatic disease (with no evidence breast disease). Our experience, like that of the literature, confirms that the breast should be extensively investigated but that blanket investigations are not usually revealing. We present guidelines for the work-up of patients presenting with axillary disease.

Treatment and survival of patients with occult breast cancer with axillary lymph node metastasis: A nationwide retrospective study

“…Several studies have reported that the 5‐year OS of OBC patients ranges from 59.4% to 100% . In the present series, the 10‐year OS of OBC patients was 88.03%.…”

Population‐based analysis of occult primary breast cancer with axillary lymph node metastasis

“…2–4,12,18–22 Two of those studies produced an improved recurrence-free survival among patients who received RT to the breast compared with patients who underwent observation only. 2–4 Although the number of patients in these studies was very small, none demonstrated a benefit from mastectomy compared with BCT plus RT.…”

“…Various authors have reported single-institution results in this clinical subset with 5-year OS rates that range from 76% to 100% (Table 4). [2][3][4]12,[18][19][20][21][22] Two of those studies produced an improved recurrence-free survival among patients who received RT to the breast compared with patients who underwent observation only. [2][3][4] Although the number of patients in these studies was very small, none demonstrated a benefit from mastectomy compared with BCT plus RT.…”

Immunohistochemically defined subtypes and outcome in occult breast carcinoma with axillary presentation

“…The frequency of OBC is reported to be 0.3-1.0%, with peak incidence at around 55 years of age [1][2][3]. Due to the low number of patients included in published series, the outcome of OBC is still unclear, though a favourable outcome has been reported in small series of patients [4][5][6][7][8].…”