AXILLARY METASTASIS FROM OCCULT BREAST-CARCINOMA - DIAGNOSIS AND MANAGEMENT

Axillary metastasis from carcinoma of an unknown primary site is an un common and difficult problem. When biopsy of an enlarged axillary node reveals adenocarcinoma, the most likely site (in a female patient) is the ipsilateral breast. From January 1977 to December 1986, 10 patien ts (eight female, two male) were treated at the University of Mississi ppi Medical Center for axillary metastasis from carcinoma of unknown p rimary. Two male patients (ages 60 and 63) were believed to have lung primaries. Both had evidence of distant metastasis at initial diagnosi s and died 2 and 7 months after presentation. Of the eight women (ages 40-72, mean 56.5 years), seven developed breast abnormalities between 6 and 39 months (mean: 15 months) after initial diagnosis, and two of these underwent modified radical mastectomy. No primary site was iden tified in the eight women. Two women had evidence of distant metastase s at initial presentation. All patients have died with disease at a me an of 42 months (range: 2-93 months). In contrast with other reported series, the outcome of patients with occult breast carcinoma presentin g as axillary adenopathy was not favorable.