In addition, the world cancer research fund estimates that 20% of all cancers diagnosed in the us are caused by a combination. Skin metastases are secondary breast cancers that form on or just below the skin. When skin metastases of an unknown primary site appear, lung cancer is the first option to be discarded in case of men, and breast cancer. Skin metastases in patients with metastatic cancer no. Metastasis is defined as a neoplastic lesion originating from another primary tumor, with which it is no longer in contact. Metastatic breast cancer from gastric and ovarian cancer, mimicking inflammatory breast cancer. Several distinct clinical patterns of metastatic breast cancer.
Skin metastases from breast cancer on mastectomy scar, dermoscopy background metastatic cutaneous lesions are seen more commonly in breast cancer than in any other malignancy in women, exceeding 20% of all cutaneous metastases 1. Up to 24% of patients with metastatic breast cancer are expected to have metastasis. Furthermore, paget disease, which is mainly considered an intraepidermic metastasis, is discussed in chap. Such metastatic lesions require biopsy and coordination with a surgical oncologist and medical oncologist to determine the treatment for stage iv disease. A 48yearold african american male with a past medical history of poorly differentiated left breast cancer. These were deemed to be 228 journal of the american academy of dermatology volume 29, number 2, part 1 lookingbill et al.
Presentation often is ambiguous because the metastases can mimic other common processes e. Every practitioner should be highly suspicious of acuteonset. Originate either from an internal malignancy or from a primary skin cancer melanoma. Diffuse cutaneous breast cancer metastases resembling. Metastases skin infiltration of hematologic neoplasms have different clinical features from cutaneous metastasis. Cutaneous metastases occur more often in breast cancer than in other diseases in women.
Skin metastases of breast cancer remain a therapeutic challenge. Cutaneous metastasis of a breast cancer diagnosed years. Excluding melanoma, breast and lung carcinomas are the main source of cm in. Skin metastases can result from spread from an internal cancer or a skin cancer, usually melanoma. This case reports a clinically remarkable cutaneous metastatic breast carcinoma. Median overall survival varied among the previous reports, ranging from. A clinicopathological analysis of cutaneous metastasis from gastric cancer in korea. Cutaneous metastases rarely develop in patients having cancer with solid tumors. Skin metastases with zosteriform distribution from internal malignancies or primary skin cancer are infrequent. Cutaneous metastases typically occur in only a small minority of breast cancer patients. Cutaneous metastases primary care dermatology society uk. In general, surgery is the primary treatment for breast cancer. Tolllike receptor 7 agonist imiquimod is an immune response modifier and can induce immunemediated rejection of primary skin malignancies when topically applied. Inflammatory breast cancer details, diagnosis, and signs.
Lung cancer is one of the most common cancers in america. Complete regression of cutaneous metastases with systemic. Pdf response of cutaneous metastases from breast cancer to. Excluding mela noma, the most common tumor to metastasize to the skin is breast cancer. Metastatic breast cancer is associated with the highest incidence of cutaneous metastases in women. Guided by imaging ultrasound, ct scan, or mri, cryoablation inserts a special freezing probe a type of catheter through the skin. Inflammatory breast cancer ibc is rare and accounts for only 15% of all breast cancers. In most cases, cutaneous metastasis develops after the initial diagnosis of the primary internal malignancy such as breast cancer and lung cancer and late in the course of the disease. Review of the literature indicates that the incidence of cutaneous metastases for all types of carcinomas ranges from 0. Pdf electrochemotherapy in the treatment of cutaneous.
Pdf excluding malignant melanoma, breast cancer has the highest incidence of cutaneous metastasis compared to any other solid. The overall incidence of cutaneous metastasis is reported to range from 0. A heavily pretreated patient with triple negative breast cancer distinguished by cutaneous metastases received p53mva vaccine in combination with pembrolizumab. Skin involvement occurs in 24% of breast cancer cases. Cryoablation may be an option to treat small, isolated metastatic breast cancer tumors in women who arent good candidates for surgery. Clinical appearance can vary, but lesions often present as isolated dermal nodules with superficial discoloration or a change in texture on the chest ipsilateral. Her cutaneous metastases regressed and after 2 cycles of therapy, a skin. Dear editor, cutaneous metastases cm are detected in about 0. The most common tumor to metastasize to the skin is breast cancer. Usually, treatment for metastatic cancer to skin involves treating the underlying cancer.
Dermoscopic findings in cutaneous metastases breast. In a prospective phase ii trial, topical imiquimod 5% was applied to all cutaneous metastases. The recognition of cm often dramatically alters therapeutic plans, especially when metastases signify persistence of cancer originally thought to be cured. Major sites of extramammary involvement, in decreasing prevalence, are the lungs, bones, liver, adrenal, brain, skin and kidneys. The probability of their occurrence ranges from about 5% in the entire population to as much as 30% in the late stages of the. Nccn guidelines for patients metastatic breast cancer nccn quick guide sheet for noninvasive breast cancer. Abstract cutaneous metastases are rare and represent a sign of poor prognosis.
Response of cutaneous metastases from breast cancer to capecitabine. The skin is a relatively uncommon site for metastases, compared with other organs such as the liver, lung and bone. Occasionally, patients with metastatic breast cancer have a firm, scar like area in the skin. Successful treatment of cutaneous metastatic breast cancer with. Male breast cancer, cutaneous metastases introduction male breast cancer mbc is a relatively rare disease accounting for only 1% of cancers in men1.
Response of cutaneous metastases from breast cancer to capecitabine article pdf available in clinical medicine. Cutaneous metastases as initial manifestation of internal neoplasias, represent only 0. The following case report is of a primary lung cancer with metastases to the breast and skin. The 5year relative survival rate for breast cancer patients varies based on the stage at diagnosis 99% in patients with localized cancer, 84% with regional lymph node involvement, 24% with distant metastases of any kind. The reported incidence of cutaneous metastases from a known primary malignancy ranges from 0. Cutaneous metastases in patients with metastatic carcinoma. Patients present with a variety of symptoms ranging from nonpainful, single or multiple, hard, firm, indurated skin. The presence of skin metastases signifies widespread systemic disease and a poor prognosis. Oncology 2 april 2008 with 488 reads how we measure reads.
A remarkable case of cutaneous metastatic breast carcinoma. Cutaneous metastases from solid tumors in general occur at a rate of about 1% per primary tumor. Estimated cutaneous metastases have been reported to occur in 0. Topical tlr7 agonist imiquimod can induce immunemediated. Palliative surgical treatment for cutaneous metastatic. Breast cancer is the second most common malignancy after melanoma to metastasize to skin. Skin metastases from breast cancer are relatively common and sometimes impair quality of life. Here we tested the hypothesis that topical imiquimod stimulates local antitumor immunity and induces the regression of breast cancer skin metastases. Unfavourable pattern of metastases in m0 breast cancer patients during 19782008. Zosteriform cutaneous metastasis from a breast carcinoma. Successful treatment of cutaneous metastatic breast cancer.
Because of the high incidence of breast cancers relative to other internal malignancies, breast cancer accounts for almost 33% of all cutaneous metastases. Kreisman h, wolkove n, finkelstein hs, cohen c, margolese r, frank h. Secondary breast cancer happens when cancer cells spread from the breast to other parts of the body. The sister mary joseph nodule is a well known cutaneous metastasis pathology. Cutaneous metastasis from an asymptomatic breast cancer. Zosteriform cutaneous metastasis from a breast carcinoma wed the reported studies of dermatomal or zosteriform metastases table 36. Breast carcinoma can cause zosteriform skin metastasis, in which, sss can be helpful in distinguishing between metastases. Keywords breast carcinoma, cutaneous metastasis, lymphatic malformation. Typically, cutaneous metastases of breast cancer manifests as a 1 to 3cm, asymptomatic, firm, pink to redbrown nodule on the chest ipsilateral to the primary tumor. Although it is often a type of invasive ductal carcinoma, it differs from other types of breast cancer in its symptoms.
Sometimes breast cancer cells can spread to the skin. Breast cancer is the most common cause of skin metastases in women. Exuberant case of cutaneous metastasis of breast cancer scielo. These numbers are far in excess to those cited for other visceral malignancies. Breast cancer is the most common solid malignancy to metastasize to skin 1, 2, 3. Secondary breast cancer that has spread to the skin skin. Breast cancer accounts for 51% of the total cases of cutaneous metastases 1, 2. Cutaneous metastasis plural metastases refers to the growth of cancer cells in the skin originating from internal cancer.
In very rare cases, skin metastasis may occur at the same time or before the primary cancer has been discovered and may be the prompt for the further thorough investigation. Cutaneous metastasis is the main cause of morbidity and mortality of cancer patients, denoting a guarded prognosis. Response of cutaneous metastases from breast cancer to. Cutaneous metastases from carcinoma breast bioline international. Cutaneous and subcutaneous metastases are not uncommon, occurring in 5% range 0. Nccn quick guide sheet for metastatic breast cancer. The metastatic capabilities of breast carcinoma are well described. Cutaneous lesions as a presenting sign of metastases in. Pdf response of cutaneous metastases from breast cancer. The incidence of breast carcinoma cutaneous metastases in patients with breast carcinoma is 23. These methods could include surgery, chemotherapy, andor radiation therapy. Cytodiagnosis of zosteriform cutaneous metastases from. Median overall sur vival in metastatic breast cancer is about 36 months pal et al. It typically presents in older men, with a peak age of 71 years1.
Cutaneous metastasis due to breast cancer in a patient. Frequent sites of metastasis include the hilar lymph nodes, adrenal glands, liver, brain, and bone. About 70% of all cutaneous metastases in women are related to breast cancer. Sato t, muto i, fushiki m, hasegawa m, hasegawa m, sakai t, et al. Metastatic cutaneous lesions are seen more commonly in breast cancer than in any other malignancy in women, exceeding 20% of all cutaneous metastases.
170 449 1507 929 399 749 668 370 1155 460 891 414 59 807 1348 669 219 1334 557 1336 1059 481 133 598 370 429 360 933 159 208