Tuesday, January 16th, 2007.

Polish Journal of Pathology. 2006;57(3):161-5. [Link]

Ribeiro-Silva A, Mendes CF, Costa IS, de Moura HB, Tiezzi DG, Andrade JM.

Department of Pathology, Ribeirao Preto Medical School, University of Sao Paulo, Brazil. arsilva@fmrp.usp.b

Abstract

Along with a brief review of the literature, we report the clinicopathologic features of 12 cases of extramammary malignancies metastatic to the breast. Histological diagnoses of the primary tumor were as follows: non-Hodgkin diffuse large B-cell lymphoma (3 patients), acute mycloid leukemia (3 patients), serous papillary adenocarcinoma, well-differentiated adenocarcinoma, squamous cell carcinoma, undifferentiated neoplasm, mesothelioma, and melanoma. The most common mammographic finding was a well-circumscribed mass with increased density but without speculation, calcifications or other signs that characterize the majority of primary carcinomas. Ultrasound revealed well-circumscribed masses without retrotumor acoustic shadowing. The interval between diagnosis of primary cancer and the appearance of breast metastasis ranged from 0 to 108 months (mean: 17, median: 1). Survival after the detection of the breast metastases ranged from 0.2 to 144 months (mean: 23, median: 9.5). In conclusion, metastasis can mimic either benign disease or primary malignancy and is often an unexpected diagnosis in a patient presenting with a breast mass. Thus, an accurate diagnosis is important to avoid unnecessary mutilating surgery. These masses generally indicate disseminated metastatic disease, with a very poor survival rate.

Glossary

adenocarcinoma

(add-en-o car-sin-o-muh). Cancer that starts in the glandular tissue, such as in the ducts or lobules of the breast.

survival rate

the percentage of survivors with no trace of disease within a certain period of time after diagnosis or treatment. For cancer, a 5-year survival rate is often given. This does not mean that people can't live more than five years, or that those who live for 5 years are necessarily permanently cured.

squamous cell carcinoma

(skwa-mus cell car-sin-oma) cancer that begins in the non-glandular cells, for example, the skin.

neoplasm

(nee-o-plas-um) an abnormal growth (tumor) that starts from a single altered cell; a neoplasm may be benign or malignant. Cancer is a malignant neoplasm.

metastasis

(meh-tas-teh-sis) the spread of cancer cells to distant areas of the body by way of the lymph system or bloodstream.

melanoma

(mel-uh-no-muh) a cancerous (malignant) tumor that begins in the cells that produce the skin coloring (melanocytes). Melanoma is almost always curable in its early stages. However, it is likely to spread, and once it has spread to other parts of the body the chances for a cure are much less.

lymphoma

(lim-foam-uh) a cancer of the lymphatic system, a network of thin vessels and nodes throughout the body. Its function is to fight infection. Lymphoma involves a type of white blood cells called lymphocytes. The two main types of lymphoma are Hodgkin's disease and non-Hodgkin's lymphoma. The treatment methods for these two types of lymphomas are very different.

leukemia

(loo-key-me-uh) cancer of the blood or blood-forming organs. People with leukemia often have a noticeable increase in white blood cells (leukocytes).

diagnosis

identifying a disease by its signs or symptoms, and by using imaging procedures and laboratory findings. The earlier a diagnosis of cancer is made, the better the chance for long-term survival.

detection

finding disease. Early detection means that the disease is found at an early stage, before it has grown large or spread to other sites. Note many forms of cancer can reach an advanced stage without causing symptoms. Mammography can help to find breast cancer early, and the PSA blood test is useful in finding prostate cancer.

cell

the basic unit of which all living things are made. Cells replace themselves by splitting and forming new cells (mitosis). The processes that control the formation of new cells and the death of old cells are disrupted in cancer.

carcinoma

(car-sin-o-ma) a malignant tumor that begins in the lining layer (epithelial cells) of organs. At least 80% of all cancers are carcinomas.

cancer

malignancy; a group of diseases typified by abnormal, generally out-of-control, cell growth.

benign

(be-nine) not cancer; not malignant.

tumor

an abnormal lump or mass of tissue. Tumors can be benign (not cancerous) or malignant (cancerous).

ultrasound

an imaging method in which high-frequency sound waves are used to outline a part of the body. The sound wave echoes are picked up and displayed on a television screen. Also called ultrasonography.

mesothelioma

a tumor derived from mesothelial tissue, such as the peritoneum (lining the abdomen) or pleura (lining the lungs). More on mesothelioma.

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