Metastases to the breast

Metastases to the breast from non-mammary primary tumours are uncommon and account for 0.5-2.0% of all breast malignancies. 

Metastases do not tend to cause retraction of the skin or nipple. Metastatic lesions are much more likely to be multiple or bilateral than primary cancers. 

Breast metastases from extra-mammary malignancies are unusual, and if present, typically indicate widely disseminated disease. They tend to be found in the subcutaneous fat, whereas primary breast cancers develop in glandular tissue.

Primary sites

The most frequent source of a metastatic breast lesion is the contralateral breast 2. The most common extra-mammary cancers that metastasise to breast are:

Like other metastasis, metastases to the breast tend to be rounded and well defined. As opposed to breast cancer, calcification is unusual.

Mammography

On mammography, metastatic lesions may manifest as single or multiple masses or as diffuse skin thickening. Metastases usually appear as round masses with circumscribed or ill-defined borders. They typically lack spiculation. Microcalcifications are rare can occur with some primary type (e.g, psammoma bodies in ovarian cancer).

Breast ultrasound

On ultrasound, metastatic masses tend to have circumscribed margins with low-level internal echoes and, occasionally, posterior acoustic enhancement. Colour Doppler interrogation most often shows increased vascularity.

On mammography several other primary breast lesions may easily mimic that of a typical well defined metastasis which may be benign or malignant:

Rarely, a metastasis to breast may be spiculated and mimic an invasive ductal carcinoma.

The first case of metastatic lesion to the breast is thought to have been reported by Trevithick in 1903 4.


Breast imaging and pathology
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Article Information

rID: 1667
System: Breast
Section: Gamuts
Synonyms or Alternate Spellings:
  • Metastasis to breast
  • Metastases to breast
  • Metastasis to the breast
  • Metastasis to the breast from an extramammary tumour
  • Metastasis to the breast from an extramammary cancer

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    Case 1: neuroendocrine tumour
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    Case 2: "miliary" from contralateral breast cancer
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    Case 3: renal cell carcinoma
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