Metastases to the breast: role of fine needle cytology samples. Our experience with nine cases in 2 years

Fulciniti, Franco; Losito, Simona; Botti, Gerardo; Mattia, Diana Di; Mura, Antonella; Pisano, Carmela; Pignata, Sandro

doi:10.1093/annonc/mdm546

Cited by 32 publications

(24 citation statements)

References 19 publications

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“…However, in our patient, the lesion was poorly defined and skin redness was observed. Similar findings from other authors are rare (7,17,25,30). Distinguishing a breast metastasis from a primary mammary adenocarcinoma, based on mammographic findings, may be extremely difficult due to the wide range of imaging manifestations of the metastatic lesions (4,5,18).…”

Section: Histopathological and Immunohistochemical Findingssupporting

confidence: 82%

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Breast metastasis from a pulmonary adenocarcinoma: Case report and review of the literature

et al. 2012

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Abstract. Breast metastasis from extra-mammary malignancy is rare. An incidence of 0.4-1.3% has been reported in the literature. The primary malignancies most commonly metastasizing to the breast are leukemia, lymphoma and malignant melanoma. We present a case of metastasis to the breast from a pulmonary adenocarcinoma, diagnosed concomitantly with the primary tumor. A 43-year-old female presented with dyspnea and a dry cough of 3 weeks' duration. A subsequent chest radiograph revealed a massive pleural effusion. Additionally, on physical examination, a poorly defined mass was noted in the upper outer quadrant of the right breast. The patient underwent bronchoscopy, simple right mastectomy and medical thoracoscopy. Following cytology, histology and immunohistochemistry, primary lung adenocarcinoma with metastasis to the breast and parietal pleura was diagnosed. Histologically, both the primary and metastatic anatomic sites demonstrated a micropapillary component, which has recently been recognized as an important prognostic factor. Although the patient received chemotherapy, she succumbed to her condition within 8 months. Accurate differentiation of metastasis from primary carcinoma is very important as the treatment and prognosis of the two differ significantly. IntroductionThe National Cancer Institute of the USA estimates that, based on current rates, 12.7% of females born today will be diagnosed with breast cancer in their lifetime (1). Although primary breast cancer is the most common malignancy of adult females, metastatic involvement of the breast is rare, with a reported frequency of 0.4-1.3% in clinical series (2-5). Despite its rarity, metastatic breast disease is an significant diagnostic clinical problem, as its treatment differs greatly from that of primary breast cancer. In 1907, Sitzentfrey was the first to publish a case of ovarian carcinoma metastatic to the breast (6). To date, a wide variety of malignancies have now been reported to metastasize to the breast and according to the literature, the most common primary tumors are melanomas and haematological malignancies (5-7). The lung is the most common cancer site in terms of incidence and mortality; however, there have only been a few published cases of pulmonary carcinomas metastasizing to the breast (8-12). Carcinomas with micropapillary components have been reported at several anatomical sites, including the breast, urinary bladder, ovary and major salivary glands (13). Micropapillary components are being increasingly recognized as prognostic predictors in lung adenocarcinomas and according to many studies, this may be a manifestation of aggressive behaviour (14,15). We report the case of a patient with breast metastasis from a pulmonary adenocarcinoma characterized by a micropapillary pattern and diagnosed in conjunction with the primary tumor. Written informed consent was obtained from the patient for publication of this case report and accompanying images. Case reportA 43-year-old, non-smoking housewife presented to the Emergency Departme...

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Section: Histopathological and Immunohistochemical Findingssupporting

confidence: 82%

“…4). (4,5,(9)(10)(11)(12)(19)(20)(21)(22)(23)(24)(25)(26)(27). Twelve of these cases were classified as adenocarcinomas (5,9,12,19,(21)(22)(23)25).…”

Section: Histopathological and Immunohistochemical Findingsmentioning

confidence: 99%

Breast metastasis from a pulmonary adenocarcinoma: Case report and review of the literature

et al. 2012

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“…Peripheral blood examination can be useful for excluding leukemia. Adenocarcinoma metastatic to the breast presenting as inflammatory mastitis can mimic IBC [11]. …”

Section: Discussionmentioning

confidence: 99%

Fine-Needle Aspiration in Suspected Inflammatory Breast Cancer: Case Series with Emphasis on Approach to Specimen Adequacy

Kumar¹,

Sayed²,

Moloo³

et al. 2011

Acta Cytologica

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Objectives: To highlight the utility of a tangential approach in the fine-needle aspiration (FNA) technique for obtaining cellular material adequate for a conclusive diagnosis in diffusely enlarged breast without a discrete lump. Study Design: FNA was performed on 5 women clinically suspected to have inflammatory breast cancer (IBC). All had unilateral diffusely enlarged breasts with peau d’orange changes of the skin. No distinct lump was palpable. The procedure was performed using a 10 cm³ syringe with a tangential approach of a 23-gauge needle in all 4 quadrants with extra passes in the antigravity areas. Rapid on-site evaluation for adequacy was done. Results: All women were of African descent within the age range of 34–57 years. One case had a recent history of lactation. FNA smears showed low-to-moderate cellularity. One case was suspicious and 4 were positive for ductal carcinoma. Core biopsy confirmed IBC in 3 cases. Two cases had a mastectomy; 1 of these cases had preoperative neoadjuvant chemotherapy. Conclusion: The approach of FNA used in these cases helped to establish the diagnosis of IBC in 4 women presenting with a diffusely enlarged and tender breast, resulting in the timely initiation of appropriate management. The technique needs to be assessed in a larger cohort of women with diffusely enlarged breast to evaluate its diagnostic utility.

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“…Recognition of metastatic spread to the breast is important to avoid unnecessary extensive surgery and for appropriate treatment. [3] In the present patient, the breast lesion appeared to be the primary with metastasis to the lung, but actually it was the reverse.…”

Section: Discussionmentioning

confidence: 49%

Squamous cell carcinoma of lung metastasizinig in breast

et al. 2012

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Metastasis in breast from extra-mammary malignancy is rare and lung is the third most common primary site when such a metastasis occurs. Small cell carcinoma and adenocarcinoma are two histological varieties of lung carcinoma that may metastasize to breast and squamous cell type is very rare. Here we report a case of squamous cell carcinoma of lung that metastasized in the breast and mimicked primary breast carcinoma.

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Metastases to the breast: role of fine needle cytology samples. Our experience with nine cases in 2 years

Cited by 32 publications

References 19 publications

Breast metastasis from a pulmonary adenocarcinoma: Case report and review of the literature

Breast metastasis from a pulmonary adenocarcinoma: Case report and review of the literature

Fine-Needle Aspiration in Suspected Inflammatory Breast Cancer: Case Series with Emphasis on Approach to Specimen Adequacy

Squamous cell carcinoma of lung metastasizinig in breast

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