TY - JOUR
T1 - Breast carcinoma presenting as axillary metastases without evidence of a primary tumor
AU - Merson, M.
AU - Andreola, S.
AU - Galimberti, V.
AU - Bufalino, R.
AU - Marchini, S.
AU - Veronesi, U.
PY - 1992
Y1 - 1992
N2 - Background. Sixty cases of axillary metastases from clinically occult breast cancer were analyzed. All cases had histologic evidence of metastatic nodes compatible with breast carcinoma. Methods. Thirty-three patients underwent breast surgery at the time of histologic diagnosis of the axillary metastases, 6 patients were treated with radiation therapy to the breast, and 17 patients did not receive any immediate treatment of the breast carcinoma (9 of these subsequently had a primary breast carcinoma) during the follow- up. Thirty-seven of 60 patients underwent adjuvant therapy (29 underwent chemotherapy and 8 underwent tamoxifen therapy). From the histologic point of view, the number of metastatic nodes was 1 in 13 patients, 2 to 3 in 10 patients, and 4 or more in 23 patients; the number of metastatic nodes was not evaluable in 14 cases. Invasion was extranodal in 92% of cases. Eighty- six percent of cases were histologically classified as Grade 3 according to Bloom and Richardson. Results. The 5-year and 10-year survival rates were 77% and 58%, respectively. The comparison between the survival curves of the patients treated with immediate surgery/radiation therapy and of the patients whose cases were followed-up without treatment to the breast showed no difference. Adjuvant treatments did not improve prognoses. Conclusions. The coexistence of a minimal (or unidentifiable) primary carcinoma with an extensive involvement of axillary nodes and a predominance of the undifferentiated histologic type, together with an unexpectedly good prognosis, makes this type of presentation an interesting example of a dissociated host resistance.
AB - Background. Sixty cases of axillary metastases from clinically occult breast cancer were analyzed. All cases had histologic evidence of metastatic nodes compatible with breast carcinoma. Methods. Thirty-three patients underwent breast surgery at the time of histologic diagnosis of the axillary metastases, 6 patients were treated with radiation therapy to the breast, and 17 patients did not receive any immediate treatment of the breast carcinoma (9 of these subsequently had a primary breast carcinoma) during the follow- up. Thirty-seven of 60 patients underwent adjuvant therapy (29 underwent chemotherapy and 8 underwent tamoxifen therapy). From the histologic point of view, the number of metastatic nodes was 1 in 13 patients, 2 to 3 in 10 patients, and 4 or more in 23 patients; the number of metastatic nodes was not evaluable in 14 cases. Invasion was extranodal in 92% of cases. Eighty- six percent of cases were histologically classified as Grade 3 according to Bloom and Richardson. Results. The 5-year and 10-year survival rates were 77% and 58%, respectively. The comparison between the survival curves of the patients treated with immediate surgery/radiation therapy and of the patients whose cases were followed-up without treatment to the breast showed no difference. Adjuvant treatments did not improve prognoses. Conclusions. The coexistence of a minimal (or unidentifiable) primary carcinoma with an extensive involvement of axillary nodes and a predominance of the undifferentiated histologic type, together with an unexpectedly good prognosis, makes this type of presentation an interesting example of a dissociated host resistance.
KW - axillary metastases
KW - breast cancer
KW - occult primary
KW - prognosis
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U2 - 10.1002/1097-0142(19920715)70:2<504::AID-CNCR2820700221>3.0.CO;2-T
DO - 10.1002/1097-0142(19920715)70:2<504::AID-CNCR2820700221>3.0.CO;2-T
M3 - Article
C2 - 1617600
AN - SCOPUS:0026718147
VL - 70
SP - 504
EP - 508
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 2
ER -