TY - JOUR
T1 - Axillary Nodal Metastases from Carcinoma of Unknown Primary (CUPAx): Role of Contrast-Enhanced Spectral Mammography (CESM) in Detecting Occult Breast Cancer
AU - Costantini, Melania
AU - Montella, Rino Aldo
AU - Fadda, Maria Paola
AU - Garganese, Giorgia
AU - Di Leone, Alba
AU - Sanchez, Alejandro Martin
AU - Franceschini, Gianluca
AU - Rinaldi, Pierluigi Maria
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - CUP syndrome
KW - axillary lymph node metastases
KW - breast imaging
KW - contrast-enhanced spectral mammography
KW - occult breast cancer
KW - CUP syndrome
KW - axillary lymph node metastases
KW - breast imaging
KW - contrast-enhanced spectral mammography
KW - occult breast cancer
UR - https://publicatt.unicatt.it/handle/10807/190441
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85107520767&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85107520767&origin=inward
U2 - 10.3390/jpm11060465
DO - 10.3390/jpm11060465
M3 - Article
SN - 2075-4426
VL - 11
SP - 1
EP - 10
JO - Journal of Personalized Medicine
JF - Journal of Personalized Medicine
IS - 6
ER -