Occult breast cancer: a case report and current management of treatment
Authors:
K. Vomáčková 1; N. Zlámalová 1; L. Veverková 2; K. Spáčilová 3; B. Donociková 4; M. Kolečková 5
Authors‘ workplace:
I. chirurgická klinika, Fakultní nemocnice Olomouc a lékařská fakulta Univerzity Palackého v Olomouci
1; Radiologická klinika, Fakultní nemocnice Olomouc a Lékařská fakulta Univerzity Palackého v Olomouci
2; Mammacentrum Olomouc, nestátní zdravotnické zařízení, Olomouc
3; Onkologická klinika, Fakultní nemocnice Olomouc a lékařská fakulta Univerzity Palackého v Olomouci
4; Ústav klinické a molekulární patologie, Fakultní nemocnice Olomouc a lékařská fakulta Univerzity Palackého, v Olomouci
5
Published in:
Rozhl. Chir., 2022, roč. 101, č. 3, s. 138-142.
Category:
Case Report
doi:
https://doi.org/10.33699/PIS.2022.101.3.138–142
Overview
Occult breast cancer is a very rare type of cancer which presents with axillary lymphadenopathy with no visible mass in the breast. Advances in imaging methods (MRI, PET/CT, PET/MRI, etc.) have enabled the detection of a large number of lesions which are not visible using basic imaging methods, such as mammography and ultrasound. To date, optimal management of this type of cancer is lacking. Generally, treatment of occult breast cancer is that of primary breast cancer with axillary lymph node involvement. This includes neoadjuvant oncological therapy, axillary dissection with adjuvant radiation therapy and either mastectomy or radiation to the breast. However, several recent studies have shown that similar results may be achieved with less radical treatment. The paper describes the case of a 62-year-old patient with occult breast cancer, the procedure and results of imaging assessments, and subsequently the treatment management. Furthermore, the paper reports on current treatment trends published in the literature.
Keywords:
MRI – Mammography – Mastectomy – PET/CT – occult breast cancer
Sources
1. Wang X. Presentation of axillary metastases from occult breast carcinoma. Chin J Clin Oncol. 2007;4:1−5. doi:10.1007/ s11805-007-0001-3.
2. de Bresser J, de Vos B, van der Ent F, et al. Breast MRI in clinically and mammographically occult breast cancer presenting with an axillary metastasis: a systematic review. Eur J Surg Oncol. 2010 Feb;36(2):114−119. doi:10.1016/j.ejso.2009.09.007. Epub 2009 Oct 12. PMID: 19822403.
3. Ofri A, Moore K. Occult breast cancer: Where are we at? Breast 2020 Dec;54:211– 215. doi:10.1016/j.breast.2020.10.012. Epub 2020 Oct 27. PMID: 33130487; PMCID: PMC7599122.
4. Zedníková I, Sůvová B, Hlaváčková M, et al. Obtížná diagnostika karcinomu prsu. Rozhl Chir. 2011;90(7):419−424.
5. Julínek S, Sečkařová D, Barnášová D, et al. Axilární metastázy okultního karcinomu prsu, kazuistika. Available at: www: http://www.linkos.cz.
6. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology, Breast cancer V.2.2022. breast.pdf (nccn.org).
7. Ge LP. Clinicopathological characteristics and treatment outcomes of occult breast cancer: a SEER population-based study. Canc Manag Res. 2018;10:4381– 4391. doi:10.2147/CMAR.S169019. PMID: 30349371; PMCID: PMC6188116.
8. Sohn G. Treatment and survival of patients with occult breast cancer with axillary lymph node metastasis: a nationwide retrospective study. J Surg Oncol. 2014;110(3):270–274. doi:10.1002/ jso.23644. Epub 2014 May 26. PMID: 24863883.
9. Macedo FI. Optimal surgical management for occult breast carcinoma: a meta-analysis. Ann Surg Oncol. 2016;23(6):1838–1844. doi:10.1245/ s10434-016-5104-8. Epub 2016 Feb 1. PMID: 26832884.
10. Kim H, Park W, Kim SS, et al. Outcome of breast-conserving treatment for axillary lymph node metastasis from occult breast cancer with negative breast MRI. Breast 2020 Feb;49:63−69. doi:10.1016/j. breast.2019.10.017. Epub 2019 Nov 6. PMID: 31734590; PMCID: PMC7375624.
11. Terada M, Adachi Y, Sawaki M, et al. Occult breast cancer may originate from ectopic breast tissue present in axillary lymph nodes. Breast Cancer Res Treat. 2018 Nov;172(1):1−7. doi:10.1007/s10549- 018-4898- 4. Epub 2018 Jul 20. PMID: 30030707.
12. Rueth NM, Black DM, Limmer AR, et al. Breast conservation in the setting of contemporary multimodality treatment provides excellent outcomes for patients with occult primary breast cancer. Ann Surg Oncol. 2015 Jan;22(1):90−95. doi:10.1245/s10434-014-3991-0. Epub 2014 Sep 24. PMID: 25249256.
13. Botty Van den Bruele A, Lavery J, Plitas G, et al. Axillary downstaging in occult primary breast cancer after neoadjuvant chemotherapy. Ann Surg Oncol. 2021 Feb;28(2):968−974. doi:10.1245/ s10434-020-08863-2. Epub 2020 Aug 19. PMID:32813202;PMCID:PMC7855271.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
![Issue 3](https://www.prolekare.cz/media/cache/resolve/journal_issue/media/image_pdf/a4f016cf4d76a6f53db25232ac37182e.jpg)
2022 Issue 3
Most read in this issue
- New trends in prostate cancer diagnostics
- Occult breast cancer: a case report and current management of treatment
- Penile amputation for sarcoma
- Risk of biochemical recurrence in patients with a positive surgical margin after radical prostatectomy