Fine‐needle aspiration cytology of metastatic ovarian carcinoma to the breast

Abstract

cytology. *a3v5 FNA of a metastatic breast cancer represents a diagnostic challenge to the cytopathologist to differentiate it from a primary breast cancer. We report seven FNAs from six patients with metastatic ovarian cancer to the breast. Its clinicopathologic and cytomorphologic features are described and compared to those reported in the literature. Materials and MethodsSeven FNAs were performed on six patients with metastatic ovarian cancer to the breast at the University of Pittsburgh Medical Center and Magee-Womens Hospital (MWH) between 1991 and 1994. The needle aspirates were performed by surgeons using 21-or 22-gauge needles. The aspirates were smeared, alcohol-fixed, and stained with Papanicolaou technique using the previously described techniques. ' Air-dried smears were prepared and stained with Diff-Quik (Baxter, Pittsburgh, PA). Cell blocks (available on three cases) were prepared using a previously described technique and were stained with hematoxylin-eosin (H&E). Special stains and immunohistochemical staining were performed on selected cases.The medical records as well as the original histology from the primary ovarian tumor and breast metastases (when a biopsy was performed) were reviewed. ResultsThe incidence of metastatic breast cancer originating from an ovariun primary at MWH for the last 6 yr was 5 of 1,519 breast cancers (0.33%) and 6 of 716 ovarian cancers (0.84%). The ages of these six patients were 35, 56,62,68, 69, and 72 years. The first patient presented with a 3 cm mass involving breast and axillary mass with an elevated serum CA-125 level 1 mo following her stage 1A ovarian cancer diagnosis. The breast FNA diagnosis was metastatic ovarian cancer, which was confirmed by breast biopsy (Fig. C-1). The second patient presented with right breast and axillary masses, a chest wall tumor, cachexia,

Metastases to the breast: A review of 33 cases

“…A few cases have been reported showing microcalcifications associated with metastatic ovarian cancer, containing psammoma bodies, and lymphoma. 24,25 In our series, we did not find any case of microcalcifications associated with MB.…”

Malignant melanoma metastatic to the breast

“…9,10 Microcalcification is distinctly uncommon, noted mainly in metastatic ovarian carcinoma containing psammoma bodies. 8,9 Metastatic nodules may mimic a primary mammary carcinoma or even a benign lesion radiographically 10 ; thus microscopic study of most lesions is necessary. Fine-needle aspiration biopsy is a useful procedure for the evaluation of both primary and metastatic mammary lesions.…”

“…Fine-needle aspiration biopsy is a useful procedure for the evaluation of both primary and metastatic mammary lesions. 1,2,5,8,11 A cytologic diagnosis of metastatic disease can replace an open surgical diagnostic procedure and lead to appropriate therapeutic treatment.…”

“…[1][2][3] Apart from hematopoietic neoplasms, malignant melanoma and lung carcinoma are the most commonly reported primary tumors to metastasize to the breast. [1][2][3][4] Fine-needle aspiration has been utilized for the diagnosis of neoplasms metastatic to the breast, [1][2][5][6][7][8] thus avoiding open surgical procedures. The distinction between a primary breast carcinoma and a metastatic neoplasm is crucial because surgical and therapeutic treatment options will vary accordingly.…”

Ovarian carcinoma presenting with axillary lymph node metastasis: A case diagnosed by fine‐needle aspiration and brief review of the literature

“…Axillary metastases of ovarian carcinoma are usually associated with breast metastases, 3,4 but they have been occasionally detected without breast involvement. 5,6 The most common type of ovarian malignancy metastasizing to the axillary lymph node is serous carcinoma, [7][8][9] Less common types based on the literature are endometrioid adenosquamous carcinoma, 10 poorly differentiated carcinoma, 11 clear-cell carcinoma, 12 and dysgerminoma 13 (Table I). The cytological spectrum of the differential diagnosis of a metastatic ovarian carcinoma in axillary lymph node principally should include breast carcinomas.…”