Breast: Occult Breast Cancer

Occult Breast Cancer

• Definition: Lymph Node Metastases with an Unknown Primary Site
• The Primary Site is Never Identified in About 30% of Cases
• Generally Represents a Poor Prognosis

Evaluation

• First Steps:
  • Physical Exam
  • Mammography
  • Biopsy Suspicious Lymph Nodes
• If Mammography Negative: Breast MRI

Treatment (If Imaging Still Unable to Identify Primary Lesions)

• Standard Treatment: Modified Radical Mastectomy (MRM)
• May Consider ALND with Whole-Breast Radiation Alone if Patient Wishes to Preserve Their Breast
• Consider Adjuvant Chemotherapy if Primary Lesion Still Unidentified