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Metastatic colonic adenocarcinoma in breast: report of two cases and review of the literature.

Kothadia JP, Arju R, Kaminski M, Ankireddypalli A, Duddempudi S, Chow J, Giashuddin S - Case Rep Oncol Med (2015)

Bottom Line: Here we present two rare cases, in which colonic adenocarcinomas were found to metastasize to the breast.By immunohistochemical staining, it was confirmed that the neoplastic components were immunoreactive to colonic markers and nonreactive to breast markers, thus further supporting the morphologic findings.It is extremely important to make this distinction between primary breast cancer and a metastatic process, in order to provide the most effective and appropriate treatment for the patient and to avoid any harmful or unnecessary surgical procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, The Brooklyn Hospital Center, An Academic Affiliate of Icahn School of Medicine at Mount Sinai, 121 DeKalb Avenue, Brooklyn, NY 11201, USA.

ABSTRACT
Metastatic adenocarcinoma to the breast from an extramammary site is extremely rare. In the literature, the most current estimate is that extramammary metastases account for only 0.43% of all breast malignancies and that, of these extramammary sites, colon cancer metastases form a very small subset. Most commonly seen metastasis in breast is from a contralateral breast carcinoma, followed by metastasis from hematopoietic neoplasms, malignant melanoma, sarcoma, lung, prostate, and ovary and gastric neoplasms. Here we present two rare cases, in which colonic adenocarcinomas were found to metastasize to the breast. In both cases, core biopsies were obtained from the suspicious areas identified on mammogram. Histopathology revealed neoplastic proliferation of atypical glandular components within benign breast parenchyma which were morphologically consistent with metastatic adenocarcinoma. By immunohistochemical staining, it was confirmed that the neoplastic components were immunoreactive to colonic markers and nonreactive to breast markers, thus further supporting the morphologic findings. It is extremely important to make this distinction between primary breast cancer and a metastatic process, in order to provide the most effective and appropriate treatment for the patient and to avoid any harmful or unnecessary surgical procedures.

No MeSH data available.


Related in: MedlinePlus

Tissue core biopsy from suspicious areas shows benign appearing breast terminal ductal-lobular units (TDLU) (blue arrows), interspersed by neoplastic colonic glands (black arrows) without any in situ carcinoma component (Hematoxylin and Eosin stain, 40x magnification).
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fig4: Tissue core biopsy from suspicious areas shows benign appearing breast terminal ductal-lobular units (TDLU) (blue arrows), interspersed by neoplastic colonic glands (black arrows) without any in situ carcinoma component (Hematoxylin and Eosin stain, 40x magnification).

Mentions: Since metastatic breast lesions can resemble benign or primary breast neoplasm in clinical examination and imaging studies, distinguishing between primary and metastatic breast lesion is not always straightforward. It is most important to reach an accurate diagnosis in order to guide the surgeons and oncologists to provide an appropriate treatment plan for the patient and to avoid any unnecessary radical surgery [1]. The standard of care is to evaluate the tissue sample through image-guided percutaneous biopsy from these lesions; core biopsy is comparatively better than fine needle aspiration biopsy due to the absence of tissue architecture in the latter and less diagnostic sensitivity and specificity comparing to core biopsy [6]. Histologic features that are more consistent with metastatic lesions include a lack of elastosis due to their fast growth, a sharp transition at the border of the tumor, and presence of the tumor in the subcutaneous tissue [5]. Also, the finding of in situ carcinoma is more supportive of a primary breast tumor [5], as opposed to a metastatic process (Figure 4).


Metastatic colonic adenocarcinoma in breast: report of two cases and review of the literature.

Kothadia JP, Arju R, Kaminski M, Ankireddypalli A, Duddempudi S, Chow J, Giashuddin S - Case Rep Oncol Med (2015)

Tissue core biopsy from suspicious areas shows benign appearing breast terminal ductal-lobular units (TDLU) (blue arrows), interspersed by neoplastic colonic glands (black arrows) without any in situ carcinoma component (Hematoxylin and Eosin stain, 40x magnification).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4390182&req=5

fig4: Tissue core biopsy from suspicious areas shows benign appearing breast terminal ductal-lobular units (TDLU) (blue arrows), interspersed by neoplastic colonic glands (black arrows) without any in situ carcinoma component (Hematoxylin and Eosin stain, 40x magnification).
Mentions: Since metastatic breast lesions can resemble benign or primary breast neoplasm in clinical examination and imaging studies, distinguishing between primary and metastatic breast lesion is not always straightforward. It is most important to reach an accurate diagnosis in order to guide the surgeons and oncologists to provide an appropriate treatment plan for the patient and to avoid any unnecessary radical surgery [1]. The standard of care is to evaluate the tissue sample through image-guided percutaneous biopsy from these lesions; core biopsy is comparatively better than fine needle aspiration biopsy due to the absence of tissue architecture in the latter and less diagnostic sensitivity and specificity comparing to core biopsy [6]. Histologic features that are more consistent with metastatic lesions include a lack of elastosis due to their fast growth, a sharp transition at the border of the tumor, and presence of the tumor in the subcutaneous tissue [5]. Also, the finding of in situ carcinoma is more supportive of a primary breast tumor [5], as opposed to a metastatic process (Figure 4).

Bottom Line: Here we present two rare cases, in which colonic adenocarcinomas were found to metastasize to the breast.By immunohistochemical staining, it was confirmed that the neoplastic components were immunoreactive to colonic markers and nonreactive to breast markers, thus further supporting the morphologic findings.It is extremely important to make this distinction between primary breast cancer and a metastatic process, in order to provide the most effective and appropriate treatment for the patient and to avoid any harmful or unnecessary surgical procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, The Brooklyn Hospital Center, An Academic Affiliate of Icahn School of Medicine at Mount Sinai, 121 DeKalb Avenue, Brooklyn, NY 11201, USA.

ABSTRACT
Metastatic adenocarcinoma to the breast from an extramammary site is extremely rare. In the literature, the most current estimate is that extramammary metastases account for only 0.43% of all breast malignancies and that, of these extramammary sites, colon cancer metastases form a very small subset. Most commonly seen metastasis in breast is from a contralateral breast carcinoma, followed by metastasis from hematopoietic neoplasms, malignant melanoma, sarcoma, lung, prostate, and ovary and gastric neoplasms. Here we present two rare cases, in which colonic adenocarcinomas were found to metastasize to the breast. In both cases, core biopsies were obtained from the suspicious areas identified on mammogram. Histopathology revealed neoplastic proliferation of atypical glandular components within benign breast parenchyma which were morphologically consistent with metastatic adenocarcinoma. By immunohistochemical staining, it was confirmed that the neoplastic components were immunoreactive to colonic markers and nonreactive to breast markers, thus further supporting the morphologic findings. It is extremely important to make this distinction between primary breast cancer and a metastatic process, in order to provide the most effective and appropriate treatment for the patient and to avoid any harmful or unnecessary surgical procedures.

No MeSH data available.


Related in: MedlinePlus