Breast metastases from extramammary malignancies: multimodality imaging aspects
Breast metastases from extramammary malignancies: multimodality imaging aspects
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DOI：
10.1259/bjr.20170197
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发表时间：
2017-01-01
影响因子：
2.6
通讯作者：
Marques, Elvira F.
中科院分区：
文献类型：
--
作者：
Bitencourt, Almir G. V.;Gama, Roberta R. M.;Marques, Elvira F.
乳腺外癌的乳腺转移是罕见的，通常与预后不良有关。最常表现出乳腺转移的乳房外肿瘤是黑色素瘤、淋巴瘤、卵巢癌、肺和神经内分泌肿瘤以及肉瘤。由于缺乏可靠和特异性的临床或放射学征象来诊断乳腺转移瘤，需要结合多种技术来鉴别这些病变与原发性乳腺癌甚至良性乳腺病变。多种成像方法可用于评估这些患者，包括乳腺X线摄影、超声、MRI、CT和正电子发射断层扫描CT。临床和影像学表现是多种多样的，取决于疾病的传播形式，并可能模仿原发性良性和恶性乳腺病变。血液播散的转移瘤常表现为局限性肿块，而淋巴播散常表现为弥漫性乳房水肿和皮肤增厚。与原发癌不同，乳腺转移瘤通常没有毛刺边缘、皮肤或乳头内陷。在某些情况下，可能会出现小分叶状或边缘不清。虽然钙化不常出现在转移性病变中，但在卵巢癌患者中更常见。虽然罕见，但在适当的临床环境下，在乳腺病变的鉴别诊断中应考虑继发性恶性肿瘤。了解最常见的影像学特征有助于提供正确的诊断和充分的治疗计划。
Breast metastases from extramammary cancers are rare and usually related to poor prognosis. The extramammary tumours most frequently exhibiting breast metastases are melanoma, lymphomas, ovarian cancer, lung and neuroendocrine tumours, and sarcomas. Owing to the lack of reliable and specific clinical or radiological signs for the diagnosis of breast metastases, a combination of techniques is needed to differentiate these lesions from primary breast carcinoma or even benign breast lesions. Multiple imaging methods may be used to evaluate these patients, including mammography, ultrasound, MRI, CT and positron emission tomography CT. Clinical and imaging manifestations are varied, depend on the form of dissemination of the disease and may mimic primary benign and malignant breast lesions. Haematologically disseminated metastases often develop as a circumscribed mass, whereas lymphatic dissemination often presents as diffuse breast oedema and skin thickening. Unlike primary carcinomas, breast metastases generally do not have spiculated margins, skin or nipple retraction. Microlobulated or indistinct margins may be present in some cases. Although calcifications are not frequently present in metastatic lesions, they occur more commonly in patients with ovarian cancer. Although rare, secondary malignant neoplasms should be considered in the differential diagnosis of breast lesions, in the appropriate clinical setting. Knowledge of the most common imaging features can help to provide the correct diagnosis and adequate therapeutic planning.