DETECTION OF PRIMARY BREAST-CANCER PRESENTING AS METASTATIC CARCINOMAOF UNKNOWN PRIMARY ORIGIN BY IN-111-PENTETREOTIDE SCAN

Women with isolated metastatic carcinoma or adenocarcinoma involving a xillary lymph nodes are a well-recognized group of unknown primary car cnoma (UPC) patients with a favorable prognosis. This group of patient s are generally treated based on the assumption that they have occult breast cancer. However, to facilitate patient access to the whole spec trum of therapies available for patients with breast cancer, including strategies involving the use of high-dose chemotherapy, a precise dia gnosis is increasingly important. In this clinical case we report the detection of a primary breast cancer by In-111-pentetreotide scanning in a woman who presented with metastatic carcinoma in axillary nodes, no palpable breast lesion, a nondiagnostic mammogram, and negative bre ast ultrasonography. Previous outcomes analysis of patients with UPC h ave emphasized the value of identifying women with breast cancer. This report suggests that the In-111-pentetreotide scan can contribute spe cific, clinically useful information in the evaluation cf women presen ting with metastatic carcinoma in axillary nodes and an occult primary and deserves prospective study in women with UPC presenting with isol ated axillary metastases.