open access: Breast manifestations of systemic diseases

Metastases from other solid organ primaries
"Breast cancer is the most common type of primary malignancy
in women, but metastatic spread to the breast from other solid
organs, although rare, has been reported 51–53 and may be the
first sign of malignancy.54..."
                           
                    ~~~~~~~~~~~~~~~~~~~

Abstract: Although much emphasis has been placed on the primary presentations of breast cancer, little focus has been placed on how systemic illnesses may affect the breast. In this article, we discuss systemic illnesses that can manifest in the breast. We summarize the clinical features, imaging, histopathology, and treatment recommendations for endocrine, vascular, systemic inflammatory, infectious, and hematologic diseases, as well as for the extramammary malignancies that can present in the breast. Despite the rarity of these manifestations of systemic disease, knowledge of these conditions is critical to the appropriate evaluation and treatment of patients presenting with breast symptoms.


References as noted above (Metastases from other solid organ primaries):

51. Akcay MN. Metastatic disease in the breast. Breast. 2002;11(6):
526–528.

52. Lee SK, Kim WW, Kim SH, et al. Characteristics of metastasis in thebreast from extramammary malignancies. J Surg Oncol. 2010;101(2):137–140.

Blogger's Note:  - excerpt from reference #52  above:


"The breast is an uncommon site for metastasis from
extramammary tumors with incidence of 0.4 - 1.3%.1,2 In
about 25–40% of cases, metastasis to the breast is the
initial manifestation of the disease.2 The common
sources of primary tumors are haematological
malignancies, malignant melanoma, lung tumors, renal
cell carcinoma, ovarian tumors, thyroid carcinomas and
small bowel carcinoid.4,6  Other tumors metastasized to
breast are prostate, stomach, malignant mesothelioma
and rhabdomyosarcoma.9"

53. Young JL Jr, Ward KC, Wingo PA, Howe HL. The incidence of
malignant non-carcinomas of the female breast. Cancer Causes Control.
2004;15(3):313–319.

54. Hamby LS, McGrath PC, Cibull ML, Schwartz RW. Gastric carcinoma
metastatic to the breast. J Surg Oncol. 1991;48(2):117–121.

Perspectives 2011: Key to Ovarian Cancer Detection - the Endocrine Society Research Affairs Endocrine News Jan 2011 Dr Lee (Chicago)

Perspective: Dr Lee (Chicago)

"About This Series
For the Bi-Point/Tri-Point perspective series of articles in Endocrine News, the topics, authors, and outside reviewers are selected by The Endocrine
Society’s Research Affairs Core Committee to explore subject areas from different angles. The authors write their articles independently and the drafts are then reviewed by contributing co-editors and by independent experts in the specific topic area.
If you have any comments about this feature, please email
endocrinenews@endo-society.org.
For archived copies of this series on more than 26 topics, please visit the
Endocrine News Web site, www.endo-society.org/endo_news/index.cfm"

EvidenceUpdates: Review: American society of clinical oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone recep

CONCLUSION The Update Committee recommends that postmenopausal women with hormone receptor-positive breast cancer consider incorporating AI therapy at some point during adjuvant treatment, either as up-front therapy or as sequential treatment after tamoxifen. The optimal timing and duration of endocrine treatment remain unresolved. The Update Committee supports careful consideration of adverse effect profiles and patient preferences in deciding whether and when to incorporate AI therapy.

Primary ovarian trabecular carcinoid tumor: a case report and literature review

INTRODUCTION: Carcinoid tumors are uncommon neoplasms in the diffuse peripheral endocrine system. Ovarian carcinoids are rare and can be primary or transplanted. Primary ovarian carcinoids make up approximately 0.5-1.7% of all carcinoid tumors.

.....The immunohistochemical study revealed a neuroendocrine origin with strong positivity for NSE, CgA and Syn. Other markers, such as a-inhibin and Calretinin, were negative. Finally, the case was diagnosed as a primary ovarian trabecular carcinoid tumor.

CONCLUSION: Primary ovarian trabecular carcinoid tumors are very rare. The patients lack clinical indicators, and final diagnosis depends on pathological examination, special staining and inmmunohistochemistry staining to confirm the neuroendocrine differentiation.

Postmenopausal Hormone Therapy: An Endocrine Society Scientific Statement abstract only/multinational statement - Journal of Clinical Endocrinology & Metabolism

Conclusions: The major conclusions related to the overall benefits and risks of MHT expressed as the number of women per 1000 taking MHT for 5 yr who would experience benefit or harm. Primary areas of benefit included relief of hot flashes and symptoms of urogenital atrophy and prevention of fractures and diabetes. Risks included venothrombotic episodes, stroke, and cholecystitis. In the subgroup of women starting MHT between ages 50 and 59 or less than 10 yr after onset of menopause, congruent trends suggested additional benefit including reduction of overall mortality and coronary artery disease. In this subgroup, estrogen plus some progestogens increased the risk of breast cancer, whereas estrogen alone did not. Beneficial effects on colorectal and endometrial cancer and harmful effects on ovarian cancer occurred but affected only a small number of women. Data from the various Women’s Health Initiative studies, which involved women of average age 63, cannot be appropriately applied to calculate risks and benefits of MHT in women starting shortly after menopause. At the present time, assessments of benefit and risk in these younger women are based on lower levels of evidence.

abstract: Clinical syndromes associated with ovarian neoplasms: a comprehensive review

Radiographics. 2010 Jul-Aug;30(4):903-19.

Functional ovarian neoplasms have unique clinical manifestations related to hormone overproduction and may give rise to a broad spectrum of clinical syndromes.

Sex cord-stromal tumors, the most common functional ovarian neoplasms, are associated with either hyperestrogenism (as in granulosa cell tumor and thecoma) or hyperandrogenism (as in Sertoli-Leydig cell tumor and Leydig cell tumor). Other, less common ovarian neoplasms that may have endocrine or nonendocrine syndromic manifestations include germ cell tumors associated with the excessive production of human chorionic gonadotropin (eg, choriocarcinoma, dysgerminoma), monodermal teratomas (eg, carcinoid tumor, struma ovarii) associated with carcinoid syndrome and hyperthyroidism, and primary epithelial ovarian cancers associated with paraneoplastic syndromes.

The application of diagnostic algorithms based on patient demographic information, clinical manifestations, laboratory findings, and cross-sectional imaging features may help identify ovarian neoplasms in complex clinical settings.

ENDO (Endocrine) 2010 News Conference - Menopause/Hormones/Aging Women

Monday, June 21

Endocrine-Disrupting Chemicals: Evidence of Impact (9:30 a.m. PDT): Frontier research on the impact of exposure to endocrine-disrupting chemicals.

Menopause: Hormones and the Aging Woman (1:30 p.m. PDT): Release of the Society’s scientific statement on postmenopausal hormone therapy and breaking research on risks associated with menopause and treatment of menopausal symptoms.

Rebuttal of "Flawed Experimental Design Reveals the Need for Guidelines Requiring Appropriate Positive Controls in Endocrine Disruption Research"

Author's Reply to Correspondence: Endocrine Effects of Aromatase Inhibitors Journal of Clinical Oncology

" It is somehow astonishing that after approximately 15 years from the first clinical article on anastrozole, exemestane, and letrozole, we still have insufficient or weak knowledge of some of the consequences of their long-term use."