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Breast malignant, males, children

Carcinoma subtypes

Metastases to breast

Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 2 October 2012, last major update October 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

See also metastases to male breast

Clinical features

● Rare (1-2% of breast tumors), usually from contralateral breast (Arch Pathol Lab Med 2008;132:931)
● Also lung, melanoma, ovary, kidney, stomach and thyroid (World J Surg Oncol 2007;5:74)
● Usually occurs in patients with advanced disease
● In children, rhabdomyosarcoma (alveolar variant) is most common metastasis to breast

Case reports

● Chordoma in 74 year old woman (APMIS 2006;114:726)
● Choriocarcinoma in 27 year old woman (AJR Am J Roentgenol 2005;184(3 Suppl):S53)
● Colonic adenocarcinoma in 63 year old woman (J Korean Surg Soc 2011;81 Suppl 1:S43)
● Colonic carcinoid in 53 year old woman (Arch Pathol Lab Med 2003;127:1373)
● GI (World J Gastroenterol 2006;12:2958, Am J Clin Pathol 2004;121:884, Asian J Surg 2006;29:95)
● Lung: small cell carcinoma in 50 year old woman (Diagn Cytopathol 2009;37:208) or squamous cell carcinoma in 48 year old woman (Anticancer Res 2008;28:1299)
● Melanoma in 47 year old woman (Diagn Cytopathol 2000;22:246)
● Neuroendocrine tumor (Histopathology 2011;59:619)
● Osteosarcoma in 15 year old girl (Australas Radiol 1999;43:108)
● Pancreatic islet cell tumor (Am J Surg Pathol 2006;30:912)
● Primary peritoneal carcinoma (Ann R Coll Surg Engl 2012;94:e57)
● Renal carcinoid tumor (Am J Surg 2006;191:799, Diagn Cytopathol 2007;35:306)
● Renal cell carcinoma in 81 year old woman (World J Surg Oncol 2007;5:25)
● Retroperitoneal leiomyosarcoma (Diagn Cytopathol 2007;35:508)
● Rhabdomyosarcoma (Pediatr Hematol Oncol 1996;13:277)
● Salivary gland tumor (Acta Cytol 2002;46:377)
● Small intestinal carcinoid (Arch Pathol Lab Med 2004;128:292, World J Surg Oncol 2006;4:15)
● Thyroid in 59 year old woman (Ann Pathol 1998;18:130)
● Various metastases may resemble inflammatory breast cancer (Breast Cancer 2008;15:315, Int J Dermatol 2007;46:303, Breast J 2009;15:176)

Gross description

● Often superficial (in soft tissue), well-circumscribed firm nodules without skin retraction or peau d’orange

Gross images

Colonic adenocarcinoma

Micro description

● Most important feature is that it does not resemble a primary breast carcinoma
● Usually no ductal carcinoma in situ (DCIS), although infiltrative pattern may resemble DCIS (Ann Diagn Pathol 2001;5:15)

Metastatic ovarian or peritoneal serous carcinoma to breast or axilla:
● Rare, but may resemble poorly differentiated ductal carcinoma or micropapillary carcinoma
● Tumors have papillary architecture, often WT1+ and GCDFP15 negative (Am J Surg Pathol 2004;28:1646, Am J Surg Pathol 1993;17:193), although breast mucinous carcinomas may also be WT1+ (Mod Pathol 2008;21:1217)

Micro images

Choriocarcinoma: antibody to hCG

Colonic adenocarcinoma

Colonic carcinoid

Lung: neuroendocrine carcinoma      Chromogranin+             Synaptophisin+

Renal cell carcinoma

Small intestinal carcinoid

Small intestinal carcinoid-chromogranin+

Cytology images

Left: medulloblastoma; right: melanoma

Negative stains

● ER, PR (usually)

End of Breast malignant, males, children > Carcinoma subtypes > Metastases to breast

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