Background: The axillary lymph node stage is one of the single most important determinants in the prognosis of breast cancer patients. The disadvantages of the two previous methods used for evaluating axillary node metastasis, i.e., axillary lymph node dissection and sentinel lymph node biopsy, have directed researchers to investigate new techniques for this purpose. The aim of the current study was to evaluate the clinical usefulness of axillary ultrasonography in detecting axillary metastasis.Methods: This study was conducted during a 12-month period. The breast cancer cases included in this study were all clinically diagnosed as stages I and II, with no prior treatment to the axillary region by surgery and/or chemo-radiotherapy. Excluded from the study group were patients with palpable axillary lymph nodes, those who had major organ failure or concomitant malignancy. All included patients with non-palpable axillary lymph nodes underwent axillary ultrasound examination. An ultrasoundguided core needle biopsy was performed on patients with suspected metastasis.Results: There were 125 female patients with a mean age of 49.6 years included in this study. From these, 16 (12.8%) cases had positive axillary sonographic findings.Pathologic evaluation of tissue specimens (taken by ultrasound-guided core needle biopsy) in 10 (62.5%) out of 16 patients were positive, and in the patient group of 6 (37.5%) cases, studies were negative. Axillary ultrasonography had a sensitivity of 35.7%, specificity of 93.8%, positive predictive value of 62.5%, and negative predictive value of 83.5%.Conclusion: The axillary ultrasonogram is a reliable technique in the determination of axillary nodal metastatic involvement in breast cancer patients. By use of this method a significant amount of complications and costs related to the previous techniques can be avoided.

Introduction: Colon cancer is the third most common cancer in gastrointestinal (GI) malignancies. Colorectal cancer most commonly metastasizes to the liver and lung. Metastasis to the breast from extramammary tumors areuncommonand metastatic colon carcinoma (MCC) to the breast is extremely rare. Case Presentation: We reported a 43-year-old woman with breast metastasis with colon origin. The patient presented with breast mass with mucinous adenocarcinoma. Conclusions: Metastasis to the breast from the colonic origin is possible. However, its occurrence is rare when mucinous adenocarcinoma of the breast mass is reported, and GI origin must be considered.

Hydatid cyst disease is one of the zoonoses caused by the larval stage of Echinococcus granulosus, mostly involving the liver and the lungs; but its complications can be seen in every site and organ. Sometimes it can cause suspicious and complicated cases that mimic malignancy. For instance, axillary involvement of hydatid cyst is very rare. It is important to differentiate hydatid cyst disease from cancer, since it may show malignant features when pulmonary or other distant organ involvement takes place. In this study, we present a case of multiple masses in the lungs and the axillary region in a 48-year-old woman. The ultrasonography was unable to detect hydatid cysts. Biological values were normal except for serum sodium (Na) and potassium (K); and enzyme-linked immunosorbent assay (ELISA) test was negative. Hydatid cyst was diagnosed while taking a biopsy from the axillary tumor.

Background: Metastases to breast and axilla from extramammary sites are uncommon and have been reported in only 2% of breast malignancies. Ovarian cancer metastatic to breast and axillary lymph nodes is extremely rare and only accounts for 0. 03%-0. 6% of all breast neoplasms. The most common histologic feature of ovarian cancer metastatic to breast is papillary serous adenocarcinoma. Differentiating the secondary breast malignancies from primary ones is crucial as the treatment and prognosis are different, which could avoid many unnecessary procedures. Prognosis is generally poor because most patients have simultaneous spread of the disease. Case presentation: A 67-year-old woman with a history of ovarian cancer, undergoing chemotherapy presented with redness and swelling in her left breast and pathologic axillary lymph nodes. Work ups revealed ovarian cancer metastases to breast and axillary lymph nodes. She underwent chemotherapy with second line chemotherapeutics. The results were satisfying and the patient is well. Conclusion: The history of cancer in patients with a breast mass, even if clinically benign, may give rise to potential metastases. Screening with physical examination and serial mammography for patients with ovarian cancer could be beneficial. Early and accurate diagnosis of breast metastatic tumors is critical for proper management and preventing unnecessary and possibly harmful procedures.

Background: Axillary lymph node metastasis (ALNM) is one of the important prognostic factors of breast cancer. The objective of this study was to assess the risk of ALNM in different molecular subtypes determined by estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (her2neu) of breast cancer. Methods: This retrospective study was conducted on patients who had undergone upfront breast conserving surgery (BCS) or modified radical mastectomy (MRM). Patients were classified as HR (hormone receptor) +/ her2neu-(ER or PR positive and her2neu negative), HR+/her2neu+ (ER or PR positive and her2neu positive), HR-/her2neu-(ER, PR and her2neu negative or triple negative or basal type), and HR-/her2neu+ (ER or PR negative and her2neu positive). The association between clinicopathological variables and ALNM was evaluated in logistic regression analyses. Results: In this study, 476 patients met the inclusion criteria, and had 67. 2% ALNM at diagnosis. ALNM was statistically significantly correlated with age ≤ 40 years (p=0. 026), tumor grade (p=0. 007), pathological tumor size (P<0. 001), estrogen receptor (P=0. 045), molecular subtypes (P=0. 021), LVI (P<0. 001), and PNI (P<0. 001). Post Hoc test revealed that HR-/her2neu+ subtypes of breast cancer had the highest and HR+/her2neu-had the lowest risk of ALNM. Conclusion: ALNM may be predicted by molecular subtypes of breast cancer. The risk of ALNM is less in TNBC although it is clinically more aggressive. These findings may play an important role in gauging the individualized axillary management in breast cancer.