Ectopic Breast Cancer Arising within an Axillary Lymph Node.

We report our experience with the diagnosis and treatment of an ectopic breast cancer arising within an axillary lymph node. The patient was a 65-year-old woman diagnosed breast cancer and axillary lymph node metastasis. We performed a partial mastectomy and axillary lymph node dissection. Postoperative pathology revealed no malignant lesions in the breast; however, a nodule in one of axillary lymph nodes had mixed benign and malignant components, leading to a diagnosis of invasive ductal carcinoma derived from ectopic mammary tissue. This case represents a very rare form of breast cancer, and the malignancy was difficult to distinguish from metastasis.

A rare case of metachronous ectopic breast cancer of the vulva / Un caso raro de cáncer de mama ectópico metacrónico de la vulva

Ectopic breast tissue can arise at any point along the primitive milk line, which runs from the axilla to the groin. The incidence of ectopic breast cancer ranges from 0.2% to 0.6%. We report the case of a 60-year-old woman with a history of left mastectomy for breast cancer one year prior to presentation, who presented with bilateral vulvar erosion found to be a moderately differentiated adenocarcinoma on biopsy. The extension workup being negative, a radical vulvectomy was performed. The postoperative course was uneventful, and the specimen's pathologic study revealed a vulvar localization of non-specific invasive breast carcinoma. It was positive for estrogen receptor and human epidermal growth factor receptor 2/neu, and negative for progesterone receptor. Adjuvant chemoradiotherapy was given to the patient. There is no dedicated guideline for both diagnosis and management of this particular tumor; the treatment is similar to that of orthotopic breast cancer. (AU)

El tejido de mama ectópico puede presentarse en cualquier punto de la línea de la leche primitiva, que discurre desde la axila a la ingle. La incidencia de cáncer de mama ectópico oscila entre el 0,2 y el 0,6%. Reportamos el caso de una mujer de 60 años con historia de mastectomía izquierda por cáncer de mama un año antes de la presentación, que acudió con erosión bilateral en la vulva, que fue considerada un adenocarcinoma moderadamente diferenciado en la biopsia. Siendo negativas las pruebas complementarias, se realizó una vulvectomía radical. El curso postoperatorio transcurrió sin incidentes, y el estudio de la muestra patológica reveló la localización en la vulva de un cáncer de mama invasivo no específico, que fue positivo para receptor de estrógenos y receptor del factor de crecimiento epidérmico humano 2/neu, y negativo para el receptor de progesterona. Se administró quimioterapia adyuvante a la paciente. No existen directrices especializadas para el diagnóstico y manejo de este tumor particular, siendo su tratamiento similar al del cáncer de mama ortotópico. (AU)

Unexpected presentation of accessory breast cancer presenting as a subcutaneous mass at costal ridge: a case report.

BACKGROUND: During embryogenesis, bilateral thickening of ectoderm from anterior axillary folds to inguinal folds, called mammary ridges or milk lines, develops into breast tissues. Only a pair in the pectoral area is spared from regression and continuously develops into normal breasts. Accessory breasts can result if the regression process is incomplete. These ectopic breasts can change physiologically and pathologically similar to normal breasts. Unsurprisingly, they are capable of turning malignant. Reported cases show the most common area for accessory breast cancer to be the axillary area. We report a rare case of accessory breast cancer over the costal ridge. CASE PRESENTATION: We present the case of a 51-year-old Asian woman who complained of an enlarged mass lower to her left breast developed over the period of 3 months while on contraceptive pills. Unaware that the mass could be an accessory breast, the primary doctor had prescribed oral contraceptives. After our patient had noticed that the mass was obviously growing, she decided to consult a surgeon as the mass continued to grow. Expected to be benign, the mass was investigated by ultrasonography and then excised surgically. A pathology report identified the mass to be a carcinoma of the ectopic breast tissue. However, sentinel lymph node biopsy showed no nodal metastasis of all four lymph nodes. Following surgery, she received chemotherapy, radiation, and antihormonal treatment. After 2 years of postoperative follow up, she remained free of disease. CONCLUSIONS: This patient was diagnosed as having accessory breast cancer which presented with a subcutaneous mass. As this condition is exceptionally rare but curable by early treatments, we recommend surgeons to consider potential malignancy when patients present with a subcutaneous mass.

Metachronous vulvar ectopic breast cancer, a case report and literature review.

•When two or more primary tumors arise at the same time, they are considered synchronous.•A metachronous tumor in a new primary that develops after an initial cancer diagnosis.•The diagnosis of vulvar breast cancer is primarily histopathologic, based on morphology and immunostaining.•Identifying a cancer as a metastasis versus as synchronous/metachronous significantly impacts staging and treatment.

Primary breast cancer of the vulva: A case report and literature review.

An elderly lady presented with a 2-year history of intermittent vaginal bleeding and later the development of a vulvovaginal mass. A core biopsy histology specimen from the mass and the left inguinal lymph node was suggestive of metastatic adenocarcinoma of breast origin. No breast lesion was detected on mammography, and axillary nodes were negative. The histopathologic features and the expression of GATA3, cytokeratin (CK)7, mammaglobin staining and estrogen and progesterone receptors led to a diagnosis of breast cancer originating from the ectopic mammary tissue in the vulva. Given the rarity of these lesions, and the lack of standard treatment guidelines, the management of the patient was extrapolated from the established breast cancer treatment guidelines. Radiotherapy and chemotherapy followed by hormone therapy with aromatase inhibitor were administered to this patient in the metastatic setting with good palliation.

Metachronous bilateral ectopic breast carcinoma: a case report.

An incomplete regression of the mammary line during embryogenesis occurs in 0.2-6% of the population, which may result in the presence of ectopic breast tissue (EBT). The development of a carcinoma in the EBT is a rare event. The authors present a case report of a 76-year-old female patient, with a lobular carcinoma in an abdominal wall EBT submitted to surgery and adjuvant chemotherapy.

Primary ectopic breast cancer of the vulva, treated with local excision of the vulva and sentinel lymph node biopsy: a case report.

Primary breast cancer fairly infrequently occurs in ectopic breast tissue, and primary ectopic breast cancer of the vulva is particularly rare. Only 26 cases have been published in the English-language literature, and there has been no report of primary breast carcinoma of the vulva in Japan. We report a rare case of primary ectopic breast cancer of the vulva that was treated with local excision of the vulva and sentinel lymph node biopsy (SLNB). The patient was a 72-year-old woman who had noticed a right vulvar tumor 10 years earlier. The tumor was excised by the Department of Plastic Surgery of our hospital. The histology of the vulvar tumor revealed an invasive ductal carcinoma of the breast, and immunohistochemical staining of the vulvar specimen showed the tumor cells to be 100% estrogen-receptor-positive and 100% progesterone-receptor-positive. All margins of resection were positive for neoplastic involvement. An additional local excision of the vulva and right inguinal SLNB were performed in our department. The intraoperative frozen section was negative for metastasis, and lymph node dissection was not performed. The final pathology was negative for residual disease, and a partially normal ductal component was present. Adjuvant hormonal therapy with an aromatase inhibitor was indicated post-operatively. The patient was asymptomatic and free of detectable disease at a 6-month follow-up. Due to the rarity of this diagnosis, there are no established guidelines for treatment. Although cases in which SLNB was performed are rare, we consider SLNB to be an effective alternative to inguinal node dissection for ectopic primary breast cancer of the vulva.

Prevalence of Ectopic Breast Tissue and Tumor: A 20-Year Single Center Experience.

BACKGROUND: Ectopic breast tissue, which includes both supernumerary breast and aberrant breast tissue, is the most common congenital breast abnormality. Ectopic breast cancers are rare neoplasms that occur in 0.3% to 0.6% of all cases of breast cancer. PATIENTS AND METHODS: We retrospectively report, using a large series of breast abnormalities diagnosed and treated, our clinical experience on the management of the ectopic breast cancer. In 2 decades, we observed 327 (2.7%) patients with ectopic breast tissue out of a total of 12,177 subjects undergoing a breast visit for lesions. All patients were classified into 8 classes, according to the classification of Kajava, and assessed by a physician examination, ultrasounds, and, when appropriate, further studies with fine needle aspiration cytology and mammography. All specimens were submitted to the anatomo-pathologist. The most frequent benign histological diagnosis was fibrocystic disease. A rare granulosa cell tumor was also found in the right anterior thoracic wall of 1 patient. Four malignancies were also diagnosed in 4 women: an infiltrating lobular cancer in 1 patient with a lesion classified as class I, and an infiltrating apocrine carcinoma, an infiltrating ductal cancer, and an infiltrating ductal cancer with tubular pattern, occurring in 3 patients with lesions classified as class IV. Only 1 recurrence was observed. We recommend an earlier surgical approach for patients with lesions from class I to IV.

Ectopic breast cancer: A case report.

Ectopic breast may be present at any site, from the axilla to the vulva, other than its normal location. Cysts, adenofibromas and rarely carcinomas have been reported in ectopic breasts. In this case report, we present a patient with ectopic breast cancer. The patient had a thickening and enlarging of her ectopic breast tissue, on the left arcus costarium. Tru-cut biopsy revealed "invasive lobular carcinoma". Left ectopic mastectomy and level I-II axillary dissection were performed and then chemotherapy+radiotherapy+endocrine therapy treatment was commenced. During follow up, the patient is doing well; in spite of R1 resection, she has no evidence of local recurrences or distant metastases.