Metastases to the Breast

Metastases to the Breast

This patient with lung cancer developed a palpable mass corresponding to a mammographic density image in an area of adipose tissue. A core needle biopsy confirmed metastatic lung carcinoma.

The most common metastatic tumor to the breast is melanoma. In this core needle biopsy, the melanoma image is present in adipose tissue and is detached from adjacent areas of breast tissue image.



  • Metastatic tumors to the breast from different primary sites



  • Metastases to the breast comprise < 3% of all breast malignancies

  • Most common presentation is palpable breast mass

    • Less common presentations are mass on imaging (about 10% with calcifications) or inflammatory carcinoma

    • Axillary and other regional lymph nodes are often enlarged

  • In 70-80% of cases, patient is known to have another malignancy

    • Metastases to the breast typically occur about 1 year after initial diagnosis

  • In 20-30% of cases, breast metastasis is 1st indication the patient has cancer

    • Many types of metastases are difficult to distinguish from primary breast cancer

    • Metastasis should be considered if cancer is negative for ER, PR, and HER2 and lacks in situ component

      • However, majority of such cancers will prove to be primary breast carcinomas


  • Breast surgery to remove metastasis and lymph node evaluation generally do not improve outcome and are not performed

    • Therefore, it is very important to distinguish metastases from primary breast carcinomas

  • Systemic treatment depends on type of metastatic cancer


  • Outcome is generally poor, as metastasis to the breast is manifestation of disseminated systemic disease


General Features

  • Most metastases present as circumscribed or ill-defined masses

    • A few present as irregular masses

    • Calcifications may be present (e.g., in papillary serous carcinomas)

  • Metastases may be present in adipose tissue near chest wall

  • Multiple masses may be present in 1 or both breasts

  • No specific features to distinguish primary carcinoma from metastasis


General Features

Jul 6, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Metastases to the Breast

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