الفهرس 
Anatomy of the Breast: A clinical ApplicationOnly 14 pages are availabe for public view
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Abstract
Background: Occult primary breast carcinoma (OBC) (pT0N+) presented with axillary lymph nodes metastases with non-detectable primary breast tumor either clinically or by imaging is considered a rare entity. This study aimed to assess outcomes after ALND and WBRT.
Methods: This is a prospective cohort study conducted on Twenty female patients with enlarged axillary lymph nodes metastasis of breast origin with occult primary tumor not detected by MRI (T0N+ breast cancer.) were recruited for ALND and WBRT with or without neoadjuvant chemotherapy.
Results: Twenty of 1823 patients (1%) diagnosed with axillary metastasis of breast origin with OBC not detected clinically and by MRI. Sixteen patients (80%) have N1 disease. Nine patients (45%) presented with ultrasound, eleven patients (55%) presented with sono-mammography, all patients underwent bilateral breast dynamic MRI. Sixteen patients (80%) were estrogen receptor–positive, four patients (20%) were HERII positive and two patients (10%) were triple negative. eighteen patients (90%) underwent ALND with WBRT and two patients (10%) underwent sentinel lymph node biopsy with WBRT. Five patients (25%) received neoadjuvant chemotherapy; two patients of five patients (40%) who received neoadjuvant chemotherapy give complete pathological response. Patients follow up after 6 months and 12 months with no local recurrence. All patients will be followed after 3 years and 5 years as regard disease free survival, nodal recurrence and distant metastasis.
Conclusion: Due to limited experience in OBC, as OBC is a rare entity the optimal treatment not yet established, but there is no difference between MRM and ALND with WBRT with or without nodal RT as regard local recurrence and disease free survival. More patients and longer follow up are needed to establish safe management of OBC.