Metastases to the breast from nonbreast solid neoplasms: presentation and determinants of survival.

Background: Metastasis to the breast is rare, but it must be considered in the differential diagnosis of a breast mass. The purpose of this study was to identify clinical characteristics and outcomes associated with this entity to identify determinants of survival.

Methods: Between 1983 and 1998, 169 patients were confirmed by pathology to have metastasis to the breast from nonbreast solid organ primary tumors at University of Texas M. D. Anderson Cancer Center. Medical records were retrospectively reviewed for clinicopathological characteristics. Survival was determined by Kaplan-Meier analysis.

Results: The median age was 51 years (range, 13-85). One hundred forty-nine (88.2%) patients had a prior history of cancer. Ninety-one (53.9%) patients presented with additional systemic metastases. The most common histology identified was melanoma (65 patients, 38.5%). In most patients (77%), the diagnosis was initially made through physical examination. The median survival from the time the breast metastasis was diagnosed was 10 months (range, 0.4-192.7). On univariate analysis, a significantly better survival was observed in patients who had no evidence of other disease at the time of diagnosis (P = .0036), patients with neuroendocrine tumors (P = .023), and patients who underwent surgical resection for breast metastases (P = .0001). On multivariate analysis, patients who did not have surgery were 88% more likely to die than those who did (P < 0.001).

Conclusions: Expected survival with metastasis to the breast is poor, therefore, local therapy should be tailored to each individual. The association between overall survival and surgical resection of metastases to the breast should be further investigated.