4th Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Chaidari, Athens, Greece.
1st Department of Surgery, National and Kapodistrian University of Athens, Laikon Hospital, Athens, Greece.
Int J Dermatol. 2020 Sep;59(9):1057-1064. doi: 10.1111/ijd.14818. Epub 2020 Mar 2.
Melanoma of the breast is an infrequent entity, presenting as either primary or metastatic from extramammary solid neoplasms. Depending on the involvement of the skin, primary malignant melanoma of the breast (PMMB) can be classified as cutaneous or noncutaneous. Cutaneous PMMB accounts for <5% of all melanomas and only 0.5% of all breast cancers. Furthermore, despite the rarity of metastatic breast neoplasms, melanoma comprises a frequent source of metastases. Metastatic potential of melanoma is associated with poor prognosis, and the majority of patients present more than one metastatic foci at the time of diagnosis. Diagnostic approach for both primary and metastatic melanomas of the breast is substantiated by fine needle aspiration (FNA) cytology along with immunohistochemistry. Nevertheless, verification of a metastatic mammary melanoma requires the discovery of a primary lesion. The mainstay of treatment for primary tumors is surgery, with radical local excision and axillary lymph node dissection or, on occasion, axillary sentinel node resection, while for metastatic tumors it depends on the specificities of the melanoma. Adjuvant therapy is always implemented. The aim of this survey is to meticulously review the literature of primary and metastatic malignant melanomas of the breast and report epidemiologic and clinicopathologic data for this rare entity. Clinical features, histogenesis, morphological, and immunochemical findings are discussed, while the role of current diagnostic and therapeutic management of this uncommon entity is emphasized.
乳房黑色素瘤是一种罕见的疾病，可分为原发性或由非乳房实体瘤转移而来。根据皮肤受累情况，原发性乳房恶性黑色素瘤（PMMB）可分为皮肤型或非皮肤型。皮肤型 PMMB 占所有黑色素瘤的<5%，仅占所有乳腺癌的 0.5%。此外，尽管转移性乳腺肿瘤罕见，但黑色素瘤是常见的转移来源。黑色素瘤的转移潜能与不良预后相关，大多数患者在诊断时已存在多个转移灶。诊断原发性和转移性乳房黑色素瘤的方法是通过细针抽吸（FNA）细胞学结合免疫组织化学来证实。然而，转移性乳腺黑色素瘤的确诊需要发现原发性病变。原发性肿瘤的主要治疗方法是手术，包括根治性局部切除和腋窝淋巴结清扫，或偶尔行腋窝前哨淋巴结切除术，而转移性肿瘤则取决于黑色素瘤的具体情况。辅助治疗总是要进行的。本综述的目的是仔细回顾原发性和转移性乳房恶性黑色素瘤的文献，并报告该罕见实体瘤的流行病学和临床病理数据。讨论了其临床特征、组织发生、形态学和免疫化学表现，强调了当前对这种罕见实体瘤的诊断和治疗管理的作用。
