Journal ArticleDOI
Occult breast cancer presenting with axillary metastases. Updated management.
Paul L. Baron,Michael P. Moore,David W. Kinne,Frank C. Candela,Michael P. Osborne,Jeanne A. Petrek +5 more
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TLDR
Mammography does not locate the majority of occult stage II breast cancers, and both breast preservation and adjuvant therapy may have roles in the management of these patients.Abstract:
• An isolated axillary lymph node metastasis in a woman without an obvious clinical primary site most frequently originates from the breast. Mastectomy has been the historical treatment of choice. A retrospective study of 35 patients was undertaken to evaluate the roles of modern mammography, breast preservation, and adjuvant systemic therapy in the management of these patients. Twenty-eight patients underwent a mastectomy, while 7 were managed by a combination of limited resection and/or axillary dissection and radiation therapy. Twenty-two (67%) of the 33 breast specimens contained carcinoma. Comparison of the pathologic results with the preoperative mammograms showed a specificity of 73%, while the sensitivity was only 29%. Actuarial 5-year survival after mastectomy or breast preservation was similar (77% and 65%, respectively). Patients with more than one positive lymph node benefited from adjuvant therapy. Mammography does not locate the majority of occult stage II breast cancers, and both breast preservation and adjuvant therapy may have roles in the management of these patients. ( Arch Surg . 1990;125:210-215)read more
Citations
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Diagnostic and therapeutic management of cancer of an unknown primary
TL;DR: It is now accepted that CUP represents a heterogeneous group of malignancies that share a unique clinical behaviour and, presumably, unique biology.
Journal ArticleDOI
Breast MR imaging in patients with axillary node metastases and unknown primary malignancy.
Susan G. Orel,Susan P. Weinstein,Mitchell D. Schnall,Carol Reynolds,Lynn M. Schuchter,Douglas L. Fraker,Lawrence J. Solin +6 more
TL;DR: MR imaging is very sensitive for the detection of mammographically and clinically occult breast cancer in patients with malignant axillary adenopathy, and offers potential not only for cancer detection but also for staging the cancer within the breast, which may be useful for treatment planning.
Journal ArticleDOI
Magnetic resonance imaging facilitates breast conservation for occult breast cancer.
TL;DR: MRI of the breast can identify occult breast cancer in many patients and may facilitate breast conservation in select women, and negative breast MRI predicts low tumor yield at mastectomy.
Journal ArticleDOI
Utility of Breast Magnetic Resonance Imaging in Patients With Occult Primary Breast Cancer
TL;DR: Breast MRI detects mammographically occult cancer in half of women with axillary metastases, regardless of breast density, suggesting MRI is a powerful tool for stage II and stage IV patients with occult primary breast cancer.
Journal ArticleDOI
Feasibility of breast preservation in the treatment of occult primary carcinoma presenting with axillary metastases.
Georges Vlastos,Marina E. Jean,Attiqa N. Mirza,Nadeem Q. Mirza,Henry Mark Kuerer,Frederick C. Ames,Kelly K. Hunt,Merrick I. Ross,Thomas A. Buchholz,Aman U. Buzdar,S. Eva Singletary +10 more
TL;DR: Comparison of treatment outcomes in patients with occult primary carcinoma with axillary lymph node metastasis who were treated with mastectomy or with intent to preserve the breast shows that these patients can be treated with preservation of the breast without a negative impact on local control or survival.
References
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Journal ArticleDOI
I. The Results of Radical Operations for the Cure of Carcinoma of the Breast.
TL;DR: It is said that little notion of the value of an operative procedure can be gained unless some attempt be made to exclude or consider apart cancers so far advanced that, however radical the operation, only a portion of the disease can be removed.
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Mammographically detected duct carcinoma in situ. Frequency of local recurrence following tylectomy and prognostic effect of nuclear grade on local recurrence.
TL;DR: Nuclear grade would appear to identify subsets of DCIS more likely to produce local failure after tylectomy alone, with duct carcinoma in situ with high‐grade nuclear morphology and comedo‐type necrosis associated with a 19% local recurrence rate after an average interval of 26 months.
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Correlations between estrogen receptor, progesterone receptor, and patient characteristics in human breast cancer.
TL;DR: Tumor size was negatively related to steroid receptor concentrations, but no relationships were observed between steroid receptors and either the number of positive axillary lymph nodes or the location of the primary tumor.
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The clinical significance of pre-invasive breast carcinoma
TL;DR: Improvements in mammography in the past 25 years have made it possible to detect before surgery many lesions with a high probability of being pre‐invasive carcinoma, and these cancers are virtually all cured by mastectomy.