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Breast Imaging

E2784. Extramammary Metastasis to the Breasts: Review of Multimodality Imaging Features

Yuen A,  Viqar M,  Rabinovich K,  Salom I,  Gyapong S. Mount Sinai Medical Center, Miami Beach, FL

Address correspondence to A. Yuen (annie.yuen@msmc.com)

Background Information: Breast metastases from extramammary malignancies are uncommon. They account for only 0.33–6.3% of all malignant neoplasms of the breast. It remains an important differential consideration and makes a significant clinical impact as treatment and prognosis is significantly different from metastasis from primary breast malignancy. Although extramammary malignancy to the breasts have nonspecific findings and have variable presentation, there are certain features that are typical and atypical of extramammary malignancy, depending on form of dissemination. Routes of metastatic disease to the breast include both lymphatic and hematogenous spread. Review and familiarity with these imaging features can be helpful to radiologist in differentiating metastasis from extramammary malignancy versus primary breast cancer and benign breast disease.

Educational Goals/Teaching Points: We will review the spectrum of multimodality imaging features typical and atypical of breast metastases from extramammary malignancies. We will review of variety of clinical presentations of breast metastases from extramammary malignancies. We will identify metastatic disease to the breast from extramammary primary from benign breast disease and primary breast malignancy.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: According to their routes of dissemination, there are certain common imaging features of metastatic diseases of the breast. Typical features of hematogenous metastases commonly appears as a single or multiple circumscribed mass whereas lymphatic dissemination often presents as diffuse breast edema and skin thickening. In contrast with primary breast cancer, breast metastases typically do not demonstrate spiculated margins and rarely have associated calcifications.

Conclusion: In patients with known malignancies, the presence of breast metastases from extramammary source should be considered as prognosis and treatment greatly differs from that of primary breast malignancy. Thus, familiarity of typical and atypical multimodality imaging features can help in identifying metastatic disease to the breast from extramammary primary from benign breast disease and primary breast malignancy.