Secondary neoplasms of the breast - A survey of the 20th century

BACKGROUND. A 90-year archive of surgical and postmortem material was revie wed to establish the incidence, presentation, and pathology of tumors secon dary to the breast. METHODS. A search was performed on all cases contained within the files of the Pathology Department of the Royal London Hospital from 1907 to 1999. RESULTS. Sixty patients were identified with unequivocal, secondary, nonmam mary neoplasms involving the breast. Hematologic tumors predominated, parti cularly among the more recent cases, with carcinoma less frequent overall b ut more numerous in the earlier part of the 20th century. There were severa l surprising and sometimes unique findings, with occasional metastases from primary tumors of the esophagus, retina, pancreas, thyroid, and skin. Othe r primary tumor sites included the stomach, lungs, and kidney. In line with expectations, the majority of tumors occurred in women. CONCLUSIONS. Secondary tumors to the breast are rare. In the current series , these tumors comprised 3% of the breast tumors in the files under review. The majority of these were metastases from the contralateral breast. Howev er, the existence of metastatic nonmammary tumors to the breast should be a ppreciated so that secondary tumors from unusual sites are not overlooked, particularly with the widespread use of fine-needle aspiration cytology and needle core biopsies for preoperative diagnosis. In fact, 0.43% of the bre ast malignancies in the current report originated from sites outside the br east. Of these one-third represented spread from an occult primary. Further more, the current data suggest a move from carcinomatous metastases to hema tologic malignancies over the last century, possibly reflecting earlier dia gnosis of the former and an increase in the prevalence of the latter. (C) 2 001 American Cancer Society.