Breast metastases from non-primary breast malignancies: What should we know?

Article type: Brief Report

Authors: Santana Valenciano, Ángela^a; | Juez Sáez, Luz Divina^a | Pérez Mies, Belén^b | Moreno, Sara Corral^a | Fidalgo, Sonia Rivas^a | Montero, Jacobo Cabañas^a

Affiliations: [a] General and Digestive Surgery Department, University Hospital Ramón y Cajal, Madrid, Spain | [b] Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain

Correspondence: [*] Corresponding author: Ángela Santana Valenciano, General and Digestive Surgery Department, University Hospital Ramón y Cajal, Ctra. de Colmenar Viejo, km. 9,100, 28034 Madrid, Spain. E-mail: santanavalenciano.a@gmail.com ORCIDs: https://orcid.org/0000-0001-6069-5543 (Á.S.V.);https://orcid.org/0000-0002-8287-9711 (L.D.J.S.);https://orcid.org/0000-0001-5764-5182 (B.P.M.);https://orcid.org/0000-0001-8998-1113 (S.C.M.);https://orcid.org/0000-0001-6509-4253 (J.C.M.)

Abstract: BACKGROUND:Metastases from extramammary malignant neoplasms are very rare, accounting for less than 2% of all breast malignancies. OBJECTIVE:The aim of this study is to describe the clinicopathological features and prognosis of breast metastases from non-primary breast malignancies at our institution. METHODS:We performed a retrospective observational study, obtaining data from electronic medical records and pathology databases between January 1985 and December 2020 for patients diagnosed with breast metastasis from non-primary breast malignancies. Only patients diagnosed by biopsy were included. RESULTS:Fifteen patients diagnosed with breast metastases from non-primary breast malignancies were included, 13 women (86,67%) and 2 men (13,33%). The median age at time of initial diagnosis was 56 years (IQR 21–68). The most frequent primary malignancy was melanoma (9/15; 60%). The median time to diagnosis of breast metastases was 65 months (IQR 13–106). The most common diagnostic modality was CT-scan (10/15; 66,67%). The median follow-up was 96 months (IQR 29–136). Eight patients underwent surgery (53,3%), being the most common surgical intervention breast-conserving surgery (5/8; 62,5%). Mortality at the end of follow-up was 53,3% (8/15). On the survival analysis, we found no differences between patients undergoing surgery and those only receiving systemic treatment [41,5 months (IQR 17,5–57,5) versus 14 months (IQR 2–24), respectively; p = 0,161]. CONCLUSIONS:Breast metastases from non-primary breast malignancies are extremely rare and represent a diagnostic and therapeutic challenge, due to the poor prognosis of these patients. Thus, arriving at the correct diagnosis is crucial to avoid unnecessary treatment in this population.

Keywords: Breast metastases, extramammary malignancies, diagnosis, treatment

DOI: 10.3233/BD-220056

Journal: Breast Disease, vol. 42, no. 1, pp. 223-228, 2023