Occult Primary Breast Cancer Presenting With Axillary Nodal Metastasis: Report of 3 Cases

Abstract

Occult primary breast cancer presenting as axillary metastasis is a very rare entity of breast cancer. Diagnosis and treatment management represent a real challenge in the absence of consensual attitude. We report 3 cases of occult breast cancer who presented with metastatic nodule in the axilla. Although histology identified a metastatic adenocarcinoma in the lymph nodes, mammography failed to detect the primary tumor. Immunohistochemistry showed that the biopsied lymph nodes were positive for both estrogen and progesterone receptors in all cases, suggesting the breast as the site of the primary tumor. Breast MRI was normal in addition to thoraco-abdomino-pelvic scan. Axillary dissection was performed with breast conservation followed by ipsilateral breast radiotherapy, then adjuvant chemotherapy. They are currently being treated with tamoxifen without evidence of disease with a median follow up of 8 months. doi: http://dx.doi.org/10.4021/jcgo42w