Breast cancer metastases

Metastases from breast cancer can be a frequent finding in routine oncoradiological practice.

Clinical presentation

With the universal use and acceptance of screening mammography, the isolated clinical presentation from metastases from breast carcinoma has become rare in clinical practice. Historically, presentation from metastases was much more common than it is now.

More commonly, the primary breast malignancy is known at the time the metastases are found. The commonly accepted dictum reads that the smaller the breast carcinoma, the less the chances of metastases.

In radiology practice, the most common presentation is an enlarged node in the axilla. Senology may or may not demonstrate a lesion in the ipsilateral breast. FNA of the node then shows metastatic adenocarcinoma cells.

Pathology

Location

Most common sites of metastases:

• bone: 58%
• lung and pleura: 26%
• contralateral lymph nodes: 16%

Less frequent sites of metastases are:

• liver
• brain
• pancreas ^3,4
• intramammary (rare)
• uvea ⁵
• orbit: forming a retrobulbar extraconal mass lesion with desmoblastic reaction resulting in enophthalmos
• pericardium
• soft tissue: rare