Bilateral breast masses as initial presentation of widely metastatic melanoma

Background and objectives: Malignant melanoma is the most rapidly increasing cancer in the world. Metastatic disease occurs in 20% of patients. Metastatic cancer to the breast is rare, but primary breast cancer is one of the leading causes of death in women. In the present study, a large personal series of breast biopsies is reviewed, and 2 cases of metastatic malignant melanoma to both breasts are reported.

Methods: A personal series of 1,200 breast biopsies from 1975 to 1998 were reviewed. In this series, 2 cases of metastatic melanoma to both breasts were identified.

Results: Two female patients, ages 31 and 34 years, were evaluated for bilateral breast masses. Both were treated with simple excision of the breast tumor. Postoperatively, both patients were found to have widespread metastatic disease to the brain, lung, and liver. Despite aggressive treatment with chemotherapy and radiation, the patients died at 6 and 22 months, respectively, after the initial presentation.

Conclusion: Bilateral breast metastasis from malignant melanoma is rare. Care must be taken to make a correct diagnosis of metastatic melanoma rather than of primary breast cancer. An incorrect diagnosis of anaplastic carcinoma can lead to major surgical procedures that are of no value. The long-term prognosis of patients with bilateral breast metastasis from malignant melanoma is poor.