Skin metastases in breast cancer: a review article

Skin metastases from breast cancer usually occur in more advanced stages of the disease, but can sometimes be the first clinical manifestation of breast cancer or the first evidence of a previous tumor recurrence. These demonstrations significantly reduce survival. Skin metastases from breast cancer...

Full description

Bibliographic Details
Main Authors: Behnaz Varaminian, Marzieh Ghalamkari, Tayeb Ramim, Masoumeh Roohaninasab
Format: Article
Language:fas
Published: Tehran University of Medical Sciences 2022-11-01
Series:Tehran University Medical Journal
Subjects:
Online Access:http://tumj.tums.ac.ir/article-1-11998-en.html
_version_ 1797978117967446016
author Behnaz Varaminian
Marzieh Ghalamkari
Tayeb Ramim
Masoumeh Roohaninasab
author_facet Behnaz Varaminian
Marzieh Ghalamkari
Tayeb Ramim
Masoumeh Roohaninasab
author_sort Behnaz Varaminian
collection DOAJ
description Skin metastases from breast cancer usually occur in more advanced stages of the disease, but can sometimes be the first clinical manifestation of breast cancer or the first evidence of a previous tumor recurrence. These demonstrations significantly reduce survival. Skin metastases from breast cancer have different manifestations. The most common manifestations are nodules. These nodules are soft, round or oval, mobile, firm, and elastic in texture and can be single or multiple, often flesh-colored, but can also be brown, bluish black, and pink to reddish brown. In the absence of a previous history of cancer, it can be difficult to diagnose the early location of metastatic cancers. However, metastases usually show histopathological similarities to the primary tumor. Soft tissue breast metastases usually have a better prognosis than breast or bone cancer metastases. Also, skin metastases from breast cancer do not necessarily have a poor prognosis as skin metastases from other malignancies. The relative risk of death from skin metastases to other malignancies is more than four times higher than skin metastases from breast cancer. Differential diagnosis includes cutaneous lymphoma, intracranial leukocyte infiltration, and cutaneous metastasis. Metastatic skin lesions are often mistaken for benign lesions. Recognizing them quickly is important to prevent long-term anti-inflammatory treatment that delays proper diagnosis. Therefore, to rule out metastasis, abnormal or nodular lesions should be considered for biopsy in patients with a history of systemic malignancy or suspected malignancy. Cutaneous metastases are usually a sign of widespread disease and may not be treatable in most cases. Treatment options include systemic and/or topical treatments. Extensive skin metastases require systemic treatment. For thicker skin metastases, radiation therapy, surgical or electrochemical resection is indicated as monotherapy or in combination. Oxygen in combination with topical 5% methotrexate (OFAMTX, 5% methotrexate in a carrier solution) is a recently described method that facilitates drug penetration into the epidermis. In the absence of visceral or lymph node metastases, OFAMTX is useful as a local skin treatment. This treatment is an effective and tolerable method for superficial skin metastases. Using local treatment in combination with systemic agents increases the overall effectiveness of treatment on skin metastases.
first_indexed 2024-04-11T05:19:01Z
format Article
id doaj.art-f2dac998c82e4e2ca4d3971a672705b5
institution Directory Open Access Journal
issn 1683-1764
1735-7322
language fas
last_indexed 2024-04-11T05:19:01Z
publishDate 2022-11-01
publisher Tehran University of Medical Sciences
record_format Article
series Tehran University Medical Journal
spelling doaj.art-f2dac998c82e4e2ca4d3971a672705b52022-12-24T05:07:14ZfasTehran University of Medical SciencesTehran University Medical Journal1683-17641735-73222022-11-01808599604Skin metastases in breast cancer: a review articleBehnaz Varaminian0Marzieh Ghalamkari1Tayeb Ramim2Masoumeh Roohaninasab3 Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. Department of Dermatology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Skin metastases from breast cancer usually occur in more advanced stages of the disease, but can sometimes be the first clinical manifestation of breast cancer or the first evidence of a previous tumor recurrence. These demonstrations significantly reduce survival. Skin metastases from breast cancer have different manifestations. The most common manifestations are nodules. These nodules are soft, round or oval, mobile, firm, and elastic in texture and can be single or multiple, often flesh-colored, but can also be brown, bluish black, and pink to reddish brown. In the absence of a previous history of cancer, it can be difficult to diagnose the early location of metastatic cancers. However, metastases usually show histopathological similarities to the primary tumor. Soft tissue breast metastases usually have a better prognosis than breast or bone cancer metastases. Also, skin metastases from breast cancer do not necessarily have a poor prognosis as skin metastases from other malignancies. The relative risk of death from skin metastases to other malignancies is more than four times higher than skin metastases from breast cancer. Differential diagnosis includes cutaneous lymphoma, intracranial leukocyte infiltration, and cutaneous metastasis. Metastatic skin lesions are often mistaken for benign lesions. Recognizing them quickly is important to prevent long-term anti-inflammatory treatment that delays proper diagnosis. Therefore, to rule out metastasis, abnormal or nodular lesions should be considered for biopsy in patients with a history of systemic malignancy or suspected malignancy. Cutaneous metastases are usually a sign of widespread disease and may not be treatable in most cases. Treatment options include systemic and/or topical treatments. Extensive skin metastases require systemic treatment. For thicker skin metastases, radiation therapy, surgical or electrochemical resection is indicated as monotherapy or in combination. Oxygen in combination with topical 5% methotrexate (OFAMTX, 5% methotrexate in a carrier solution) is a recently described method that facilitates drug penetration into the epidermis. In the absence of visceral or lymph node metastases, OFAMTX is useful as a local skin treatment. This treatment is an effective and tolerable method for superficial skin metastases. Using local treatment in combination with systemic agents increases the overall effectiveness of treatment on skin metastases.http://tumj.tums.ac.ir/article-1-11998-en.htmlbreast cancermetastasesystemic treatmenttopical.
spellingShingle Behnaz Varaminian
Marzieh Ghalamkari
Tayeb Ramim
Masoumeh Roohaninasab
Skin metastases in breast cancer: a review article
Tehran University Medical Journal
breast cancer
metastase
systemic treatment
topical.
title Skin metastases in breast cancer: a review article
title_full Skin metastases in breast cancer: a review article
title_fullStr Skin metastases in breast cancer: a review article
title_full_unstemmed Skin metastases in breast cancer: a review article
title_short Skin metastases in breast cancer: a review article
title_sort skin metastases in breast cancer a review article
topic breast cancer
metastase
systemic treatment
topical.
url http://tumj.tums.ac.ir/article-1-11998-en.html
work_keys_str_mv AT behnazvaraminian skinmetastasesinbreastcancerareviewarticle
AT marziehghalamkari skinmetastasesinbreastcancerareviewarticle
AT tayebramim skinmetastasesinbreastcancerareviewarticle
AT masoumehroohaninasab skinmetastasesinbreastcancerareviewarticle