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Axillary Nodal Metastases from Carcinoma of Unknown Primary (CUPAx): Role of Contrast-Enhanced Spectral Mammography (CESM) in Detecting Occult Breast Cancer

Axillary lymph node metastases of occult breast cancer (CUPAx) is an unusual condition that represents both a diagnostic and therapeutic challenge. The first steps in the diagnostic work-up of patients with CUPAx are the histological analysis of the lymph node metastasis and the execution of basic b...

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Autores principales: Costantini, Melania, Montella, Rino Aldo, Fadda, Maria Paola, Garganese, Giorgia, Di Leone, Alba, Sanchez, Alejandro Martin, Franceschini, Gianluca, Rinaldi, Pierluigi Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225076/
https://www.ncbi.nlm.nih.gov/pubmed/34070278
http://dx.doi.org/10.3390/jpm11060465
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author Costantini, Melania
Montella, Rino Aldo
Fadda, Maria Paola
Garganese, Giorgia
Di Leone, Alba
Sanchez, Alejandro Martin
Franceschini, Gianluca
Rinaldi, Pierluigi Maria
author_facet Costantini, Melania
Montella, Rino Aldo
Fadda, Maria Paola
Garganese, Giorgia
Di Leone, Alba
Sanchez, Alejandro Martin
Franceschini, Gianluca
Rinaldi, Pierluigi Maria
author_sort Costantini, Melania
collection PubMed
description Axillary lymph node metastases of occult breast cancer (CUPAx) is an unusual condition that represents both a diagnostic and therapeutic challenge. The first steps in the diagnostic work-up of patients with CUPAx are the histological analysis of the lymph node metastasis and the execution of basic breast diagnostic imaging (mammography and ultrasound). In the case of occult breast cancer, breast Magnetic Resonance (MR) must be performed. Breast MR identifies a suspicious lesion in many patients and second-look ultrasound detects a corresponding ultrasound alteration in about half of cases, allowing the performance of a US-guided biopsy. In the case of an MR-only lesion, MR-guided biopsy is mandatory. We present a case of CUPAx in which contrast-enhanced spectral mammography (CESM) is used to help the detection of occult breast cancer and to guide stereotactic vacuum breast biopsy (VABB). CESM is a new breast imaging technique that is proving to have good performance in breast cancer detection and that is showing potential in the identification of occult breast cancer in a CUPAx setting. The use of an innovative and personalized breast imaging approach in breast cancer patients improves diagnostic possibilities and promises to become the focus in decision strategies.
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spelling pubmed-82250762021-06-25 Axillary Nodal Metastases from Carcinoma of Unknown Primary (CUPAx): Role of Contrast-Enhanced Spectral Mammography (CESM) in Detecting Occult Breast Cancer Costantini, Melania Montella, Rino Aldo Fadda, Maria Paola Garganese, Giorgia Di Leone, Alba Sanchez, Alejandro Martin Franceschini, Gianluca Rinaldi, Pierluigi Maria J Pers Med Case Report Axillary lymph node metastases of occult breast cancer (CUPAx) is an unusual condition that represents both a diagnostic and therapeutic challenge. The first steps in the diagnostic work-up of patients with CUPAx are the histological analysis of the lymph node metastasis and the execution of basic breast diagnostic imaging (mammography and ultrasound). In the case of occult breast cancer, breast Magnetic Resonance (MR) must be performed. Breast MR identifies a suspicious lesion in many patients and second-look ultrasound detects a corresponding ultrasound alteration in about half of cases, allowing the performance of a US-guided biopsy. In the case of an MR-only lesion, MR-guided biopsy is mandatory. We present a case of CUPAx in which contrast-enhanced spectral mammography (CESM) is used to help the detection of occult breast cancer and to guide stereotactic vacuum breast biopsy (VABB). CESM is a new breast imaging technique that is proving to have good performance in breast cancer detection and that is showing potential in the identification of occult breast cancer in a CUPAx setting. The use of an innovative and personalized breast imaging approach in breast cancer patients improves diagnostic possibilities and promises to become the focus in decision strategies. MDPI 2021-05-25 /pmc/articles/PMC8225076/ /pubmed/34070278 http://dx.doi.org/10.3390/jpm11060465 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Costantini, Melania
Montella, Rino Aldo
Fadda, Maria Paola
Garganese, Giorgia
Di Leone, Alba
Sanchez, Alejandro Martin
Franceschini, Gianluca
Rinaldi, Pierluigi Maria
Axillary Nodal Metastases from Carcinoma of Unknown Primary (CUPAx): Role of Contrast-Enhanced Spectral Mammography (CESM) in Detecting Occult Breast Cancer
title Axillary Nodal Metastases from Carcinoma of Unknown Primary (CUPAx): Role of Contrast-Enhanced Spectral Mammography (CESM) in Detecting Occult Breast Cancer
title_full Axillary Nodal Metastases from Carcinoma of Unknown Primary (CUPAx): Role of Contrast-Enhanced Spectral Mammography (CESM) in Detecting Occult Breast Cancer
title_fullStr Axillary Nodal Metastases from Carcinoma of Unknown Primary (CUPAx): Role of Contrast-Enhanced Spectral Mammography (CESM) in Detecting Occult Breast Cancer
title_full_unstemmed Axillary Nodal Metastases from Carcinoma of Unknown Primary (CUPAx): Role of Contrast-Enhanced Spectral Mammography (CESM) in Detecting Occult Breast Cancer
title_short Axillary Nodal Metastases from Carcinoma of Unknown Primary (CUPAx): Role of Contrast-Enhanced Spectral Mammography (CESM) in Detecting Occult Breast Cancer
title_sort axillary nodal metastases from carcinoma of unknown primary (cupax): role of contrast-enhanced spectral mammography (cesm) in detecting occult breast cancer
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225076/
https://www.ncbi.nlm.nih.gov/pubmed/34070278
http://dx.doi.org/10.3390/jpm11060465
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