Case

A 59 year old female patient comes to your practice for a routine breast exam. She informs you that she knows how to administer self-breast exams and does so on a regular basis. She said she feels directly around the areola and has some concerns about what she is feeling on her left breast. When you administer a clinical breast exam, you find a sizeable lump at the 5cm, 11 o’clock location on the left breast located close to the skin. You schedule the patient for further imaging which shows a mass and large, swollen lymph nodes.

Question 3/3 - Where would you review for high probability metastatic spread?

Click on your selected option(s) below  (correct = 5, over-thinking = 6+)

Case Complete

Correct!  The breasts are interconnected by lymphatic channels. Cells from more medially located tumors have a fair probability of passing across to the other breast.

Unlikely. Typical cancer metastatic spread occurs to tissues with high perfusion and abundant microvasculature, spread into the limbs is a low probability event.

Correct! Due to the high flow and abundant microvasculature the brain is a common site for metastatic spread of breast cancer. 

Correct! Due to the high flow and abundant microvasculature the liver is a common site for metastatic spread of breast cancer. Indeed, liver is a high probability target for many/most types of metastatic cancer.

Correct! Due to the high flow and abundant microvasculature the lungs is a common site for metastatic spread of breast cancer. Indeed, since all blood circulates with each cycle through the lungs, they are high probability target for many/most types of metastatic cancer.

Unlikely.  Cancer types have secondary target preferences, which you will cover more of with cancer biology. Interesting, breast cancer has low probability of spreading to the heart. This highest probability of causing a secondary heart cancer is from a malignant melenoma (about half of all secondary heart cancers originate from a melenoma) and lung cancer.

Correct!  Bone is richly vascularized and a common location for secondary metastatic spread from multiple types of cancer including breast cancer.