scholarly journals Atypical axillary lymphadenopathy mimicking an occult breast carcinoma in a patient diagnosed with sarcoidosis: case report

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Paula Clarke ◽  
Carolina Nazareth Valadares ◽  
Douglas de Miranda Pires ◽  
Nayara Carvalho de Sá
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Breast Lesions ◽  
Axillary Lymph ◽  
Axillary Lymphadenopathy ◽  
Granulomatous Lymphadenitis ◽  
Occult Breast Carcinoma

Introduction: Occult breast carcinoma is a rare presentation of breast cancer, with histological evidence of axillary lymph node involvement and clinical and radiological absence of malignant breast lesions. Its survival is similar to that of the usual presentation. The treatment consists of modified radical mastectomy or axillary drainage with breast irradiation, resulting in similar survival, associated with systemic therapy according to the staging. Neoadjuvant therapy should be considered in N2-3 axillary cases. Differential diagnoses of axillary lymphadenopathies include: non-granulomatous causes (reactive, lymphoma, metastatic carcinoma) and granulomatous causes (infectious – toxoplasmosis, tuberculosis, sarcoidosis, atypical mycobacteria). Objectives: To report the case of a patient who needed a differential diagnosis among the various causes of axillary lymphadenopathy. Methods: This is a literature review conducted in the PubMed database, using the keywords "granulomatous lymphadenitis", "breast sarcoidosis", "occult breast cancer". Inclusion and exclusion criteria were applied. Case report: V.F.S., female, 51 years old, was referred to an evaluation of axillary lymphadenopathy in May 2019. She was followed by the department of pulmonology due to mediastinal sarcoidosis since 2017. Physical examination indicated breasts without changes. Axillary lymph nodes had increased volume and were mobile and fibroelastic. Mammography revealed only axillary lymph nodes with bilaterally increased density, and the ultrasound showed the presence of atypical bilateral lymph nodes. Neither presented breast lesions. Axillary lymph node core biopsy was compatible with granulomatous lymphadenitis. This result corroborates the diagnosis of sarcoidosis affecting peripheral lymph nodes. The patient was referred back to the department of pulmonology, with no specific treatment since she is oligosymptomatic. Discussion: Despite the context of benign granulomatous disease, malignancy overlying the condition of sarcoidosis must be ruled out. The biopsy provided a safe and definitive diagnosis, excluding the possibility of occult breast carcinoma. The patient will continue to undergo breast cancer screening as indicated for her age and usual risk. Conclusion: In the presentation of axillary lymphadenopathy, the mastologist must know the various diagnoses to be considered. The most feared include lymphoma and carcinoma metastasis with occult primary site. A proper workup can determine the diagnosis and guide the appropriate treatment.

Positron emission tomography/computed tomography (PET/CT) as a biomarker of pathologic response to neoadjuvant chemotherapy in breast carcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e21147-e21147
Author(s):  
Catherine M. Kelly ◽  
Clare Smith ◽  
Susan Conlon ◽  
Reem Salman ◽  
John McCaffrey ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Breast Cancer Subtype ◽  
Standardized Uptake Value ◽  
Predictive Biomarkers ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Pet Ct

e21147 Background: Pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast carcinoma is prognostic. Predictive biomarkers for pCR include early response to NAC, estrogen receptor (ER) negativity, HER2 positivity, and high Ki67. We assessed whether absence of fluoro-deoxy glucose (FDG) uptake measured by standardized uptake value (SUV) after NAC would predict pCR. Methods: We identified 23 patients (pts) who had PET/CT scanning pre and post NAC. We examined breast cancer subtype, chemotherapy (CT) regimen, number of cycles of CT given, clinical and pathological staging data and changes in SUV in the breasts and lymph nodes pre and post NAC. pCR was defined as no residual cancer in the breast or axillary lymph nodes. Results: Median age at diagnosis was 46 years (IQR; 37 to 56). Median tumor size at diagnosis was 30mm (IQR; 25 to 43) and 19 pts (83%) had node positive breast cancer. Most tumors were ductal (n=22) with 1 lobular cancer. Preoperatively 95% received all CT. All HER2+ pts received Trastuzumab. Anthracycline/taxane based regimens were most frequently given in 22 cases, 1 received lapatinib/trastuzumab. Five tumors (21.7%) were ER+/HER2+; 14 (60.9%) ER+/HER2-; 2 (8.7%) ER-/HER2+ and 2 (8.7%) were ER-/HER2-. All tumors were high (n=9, 39.1%) or intermediate grade (n=14, 61%). SUV was significantly lower post NAC (p=0.035). We observed no SUV uptake in breast or lymph nodes in 15 cases (65.2%) post NAC, these corresponded to; ER+HER2+ 4/5 (80%); ER+HER2- 7/15 (46.7%); ER-HER2- 2/2(100%), ER-HER2+ 2/2(100%). Absent SUV uptake post NAC was associated with a pCR (breast and lymph nodes) in 5/15 (33%) of pts (ER+HER2+ n=1, ER+HER2- n=1, ER-HER2- n=2, ER-HER2+ n=1). Ten of 15 tumors (67%) had no SUV uptake in the breast post NAC and 7 (47%) were associated with a pCR. There was a trend toward increased odds of pCR with no SUV uptake post NAC (OR 2.76; 95% CI 0.85 to 8.94: P= 0.09). Overall rate of pCR was 21.7% (n=5). Conclusions: A non-statistically significant trend toward increased odds of pCR with no SUV uptake post NAC was observed. Larger subtype-specific breast cancer cohorts will be required to determine the value of PET/CT as a predictive biomarker for pCR.

scholarly journals Comparison of TNF-α and TGF-β Expression in Breast Cancer Tissues-with and without Axillary Lymph Node Metastasis

2018 ◽  
Vol 12 (1) ◽  
pp. 1
Author(s):  
Ayu Tyasmara ◽  
Willy Sandhika
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Axillary Lymph Node Metastasis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Lymph Nodes Metastasis ◽  
Tnf Α ◽  
Paraffin Block ◽  
Cancer Tissues

Background: Breast carcinoma dynamics can be seen from the inflammatory mediator produced and some of expressed cytokine mediators mostly found in breast cancer tissues are TNF-α and TGF-β. This research analyzed TNF-α and TGF-β influence in axillary lymph nodes metastasis to prove the role of cytokines in breast cancer dynamics and to be taken as prognosis. Methods: This research used paraffin block of breast carcinoma in various stages of axillary lymph nodes metastasis and TNF-α and TGF-β antibody to observe the expressions. Result: There were significant differences in TNF-α expressions improvement with p < 0.05 in lymph nodes metastasis N1 (13.18%) and TNF-α expressions reduction in lymph nodes metastasis N2 (52.27%) and N3 (27.27%) compared with lymph nodes without metastasis (52.73%). There were no significant differences in TGF-β expressions of all N groups. Conclusion: The result stated that TNF-α cytokines can be used as biomarker independently predicting breast carcinoma prognosis and progressivity. ABSTRAKLatar Belakang: Dinamika karsinoma payudara tercermin dari mediator inflamasi yang dihasilkannya dan salah satu mediator sitokin yang terekspresi banyak pada jaringan tumor payudara adalah TNF-α and TGF-β. Kami menganalisis pengaruh TNF-α dan TGF-β pada metastasis kelenjar getah bening aksila untuk membuktikan peran sitokin dalam dinamika kanker payudara dan untuk dimanfaatkan sebagai alat prognosis. Metode: Penelitian ini menggunakan blok parafin karsinoma payudara pada berbagai stadium metastasis kelenjar getah bening aksila dan menggunakan antibodi TNF-α dan TGF-β untuk mendeteksi ekspresinya. Hasil: Hasil penelitian ini didapatkan perbedaan peningkatan ekspresi TNF-α yang signifikan dengan p < 0,05 pada metastasis kelenjar getah bening N1 (73,18%) dan penurunan ekspresi TNF-α pada metastasis kelenjar N2 (52,27%) dan N3 (27,27%) dibandingkan dengan tanpa metastasis (52,73%). Tidak ada perbedaan signifika n pada ekspresi TGF-β antar semua kelompok N. Kesimpulan: Hasil ini menyatakan sitokin TNF-α dapat dipakai sebagai biomarker untuk memprediksi progresifitas dan prognosis karsinoma payudara secara independen

scholarly journals Microinvasive Breast Carcinoma with Extensive Involvement of Level III Axillary Lymph Nodes: a Case Report

1998 ◽  
Vol 28 (1) ◽  
pp. 47-49 ◽  
Author(s):  
K. Fujii ◽  
T. Fukutomi ◽  
H. Tsuda ◽  
S. Akashi-Tanaka ◽  
T. Nanasawa ◽  
...  
Keyword(s):  
Case Report ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Extensive Involvement

Axillary Metastasis as First Symptom of Occult Breast Cancer: A Case Report

2002 ◽  
Vol 88 (6) ◽  
pp. 532-534 ◽  
Author(s):  
Fabrizio Maria Frattaroli ◽  
Alessandro Carrara ◽  
Anna Maria Conte ◽  
Giuseppe Pappalardo
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Histological Examination ◽  
Axillary Lymph Node Metastasis ◽  
Axillary Lymph ◽  
Axillary Metastasis ◽  
Occult Breast Cancer ◽  
The Right

Axillary lymph node metastasis from an occult breast carcinoma is a rare occurrence. We report this condition in a 59-year-old woman who presented with a swelling in the right axilla. No breast mass was clinically evident. Mammography, ultrasonography and multiple random fine-needle breast biopsies yielded no pathological findings. No extramammary primary lesions were present. Axillary sampling was performed and histological examination revealed the presence of metastatic adenocarcinoma in three of the 12 dissected lymph nodes. Estrogen receptors were positive and immunohistochemistry pointed to a breast origin. All these data were suggestive of occult breast cancer. The patient refused any further treatment but accepted clinical and radiological follow-up. Eight years later mammography revealed in the same breast a 10-mm nodule containing microcalcifications, which was not evident at physical examination. The patient underwent a lumpectomy. Intraoperative histology was positive for breast carcinoma and complete axillary clearance was performed. Histological examination revealed a lobular invasive breast carcinoma and the presence of micrometastasis in one of the 23 removed lymph nodes. The patient was given radiotherapy to the breast and axilla and tamoxifen. At present, one year after the appearance of the primary tumor, she is free of disease. Based on this case report we suggest an eclectic approach in the management of patients with axillary metastasis from occult breast cancer, depending on the clinical, pathological and biological findings.

scholarly journals TREATMENT OF BREAST CANCER WITH METASTATIC CONTRALATERAL AXILLARY LYMPH NODES: CASE REPORT AND LITERATURE REVIEW

2020 ◽  
Vol 18 (6) ◽  
pp. 31-38
Author(s):  
V. A. Amosova ◽  
A. V. Petrovsky ◽  
M. V. Chernykh ◽  
E. I. Kovalenko ◽  
M. A. Frolova ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Literature Review ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph

scholarly journals Occult primary breast cancer presenting with brachial plexopathy: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2098564
Author(s):  
Karen L Zhao ◽  
Yusha Liu ◽  
Kathryn P Scherpelz ◽  
Dennis S Kao ◽  
Jeffrey B Friedrich
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Lymph Nodes ◽  
Primary Breast Cancer ◽  
Unusual Case ◽  
Distant Metastases ◽  
Axillary Lymph Nodes ◽  
Brachial Plexopathy ◽  
Axillary Lymph ◽  
Occult Breast Cancer

Breast cancer affects about one in eight women over the course of her lifetime. Occult breast cancer, in which primary breast cancer is detected without evidence of disease in the breast itself, comprises up to 1% of new diagnoses; this is typically detected from abnormal axillary lymph nodes, and distant metastases are rare. Here, we present an unusual case of occult breast cancer presenting as upper extremity pain, edema, and weakness, with a metastatic mass to the brachial plexus being the only site of disease.

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