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Vol. 110. Issue 3.
Pages 181-256 (April 2019)
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Vol. 110. Issue 3.
Pages 181-256 (April 2019)
Original Article
DOI: 10.1016/j.adengl.2018.12.009
Cutaneous Metastases From Breast Cancer: An 8-Year Review of Cases at a Tertiary Care Hospital
Metástasis cutáneas de cáncer de mama: 8 años de revisión en un centro de tercera complejidad
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D.P. Bastarda,
, M.L. Bollea-Garlattia, A. Belattia, M.C. Pugab, M.N. Hernándezc, L.D. Mazzuoccoloa
a Departamento de Dermatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
b Departamento de Investigación, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
c Departamento de Ginecología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Tables (5)
Table 1. Clinical Presentations of Cutaneous Metastases From Breast Cancer Described in the Literature.
Table 2. Cutaneous Metastasis Sites and Classification by Location in 31 Patients With Breast Cancer.
Table 3. Immunohistochemical Changes Observed in 5 Patients.
Table 4. Median Time to Death From Diagnosis of Cutaneous Metastasis in Relation to Detection of Visceral Metastasis.
Table 5. Median Time to Death by Site of Cutaneous Metastasis.
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Abstract
Background and objectives

Breast cancer is the most common cause of cutaneous metastases. In our review of the literature, we found no studies that have investigated the prevalence of cutaneous metastases from breast cancer in Latin America or compared survival in relation to the site of cutaneous involvement or the presence of visceral metastases.The aims of this study were to characterize the prevalence and clinical features of cutaneous metastases from breast cancer and analyze survival in relation to site of involvement and the concomitant presence of visceral metastases.

Materials and methods

Retrospective cohort study. We evaluated patients with breast cancer and histologically confirmed cutaneous metastases.

Results

Data from 914 patients with breast cancer seen between 2007 and 2014 were analyzed. Thirty-one of the patients, all women, had cutaneous metastases (prevalence, 3.4%; 95% CI, 2.3%-4.7%). The most common form of metástasis was nodular, metachronous, and asymptomatic.There were discrepancies between the immunohistochemical findings for the primary tumor and the metastases in 5 of 21 women. The metastases were locorregional in 23 patients and distant in 8. No differences were observed between patients with locorregional and distant metastases for survival after diagnosis of the primary tumor (median of 4.7 vs. 4.8 years; P=.085) or the cutaneous metastases (median of 2.9 vs. 1.1 years, P=.06). Women with a simultaneous diagnosis of cutaneous and visceral metastases had the shortest survival.

Conclusions

This is the first study in Latin America to estimate the prevalence of cutaneous metastases from breast cancer and we found it to be lower than rates reported for other parts of the world.

Keywords:
Cutaneous metastases
Skin metastases
Breast cancer
Resumen
Introducción y objetivos

El cáncer de mama es la causa más frecuente de metástasis cutáneas. En la literatura revisada no hallamos estudios que estimen la prevalencia de las mismas en Latinoamérica ni que comparen la sobrevida con relación a la localización de las metástasis cutáneas y al diagnóstico de metástasis viscerales.

Los objetivos de este trabajo fueron: describir prevalencia, clínica y sobrevida de las metástasis cutáneas de acuerdo con la localización y con relación al diagnóstico de metástasis viscerales.

Materiales y métodos

Cohorte retrospectiva. Se evaluó a pacientes con cáncer de mama con metástasis cutáneas confirmadas por histopatología.

Resultados

Se analizó a 914 pacientes con cáncer de mama en el período 2007-2014. Presentaron metástasis cutáneas 31 pacientes (prevalencia 3,4%, IC del 95%: 2,3%-4,7%), todas mujeres. La forma nodular, metacrónica y asintomática fue la más frecuente.

En 5/21 pacientes hubo discordancia en la inmunohistoquímica entre el tumor primario y la metástasis cutánea. En 23 pacientes las metástasis cutáneas fueron locorregionales y en 8, a distancia. Entre estos 2grupos, no hubo diferencias en la sobrevida desde el diagnóstico del tumor primario (mediana 4,7 y 4,8 años respectivamente; p = 0,85) ni desde el diagnóstico de las metástasis cutáneas (mediana 2,9 años y 1,1 años; p = 0,06). La menor sobrevida la presentaron las pacientes con diagnóstico simultáneo de metástasis cutánea y visceral.

Conclusiones

Este es el primer estudio en Latinoamérica que estima la prevalencia de metástasis cutáneas de cáncer de mama, siendo inferior a la comunicada por autores de otras regiones del mundo.

Palabras clave:
Metástasis cutáneas
Metástasis en piel
Cáncer de mama

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