malignant breast melanoma

Malignant Breast Melanoma: A Rare but Serious Condition

Malignant breast melanoma, also known as primary malignant melanoma of the breast (PMMB), is a rare and serious form of cancer that affects the breast. It accounts for less than 5% of all malignant melanomas and only 0.5% of all breast cancers [12][13].

Characteristics

Malignant breast melanoma can present as either primary or metastatic disease, with patients possessing BRCA2 mutations being at an increased risk for this condition [14]. The tumor often appears as a circumscribed mass or masses without spiculations or microcalcifications at mammography and may have a variety of imaging appearances at ultrasound [14].

Symptoms

The early stage of malignant breast melanoma is typically characterized by a painless mass with unclear borders, fixed, hard, poor mobility, and progressive tumor enlargement [3]. Additional symptoms may include patches with ulceration, oozing, or bleeding, as well as satellite moles that grow in the upper and lower epidermal layers [6].

Incidence

The incidence of primary cutaneous melanoma has increased steadily for several decades and remains the most lethal form of cutaneous neoplasm. If diagnosed in the early stages, melanoma has high survival rates, approximating 94% [11]. However, metastatic melanoma is a more serious condition with a poorer prognosis.

References

[1] Metastatic spread of melanoma to the breast is a far less occurrence than primary breast cancer constituting 1.3-2.7% of all malignant breast tumors. [3] The early stage is a painless mass with unclear borders, fixed, hard, poor mobility, and progressive tumor enlargement. [6] Additional melanoma signs include patches with ulceration, oozing, or bleeding, as well as satellite moles. [11] If diagnosed in the early stages, melanoma has high survival rates, approximating 94%. [12] Malignant melanoma rarely affects the breast, accounting for less than 5% of all malignant melanomas. [13] Melanoma of the breast is an infrequent entity, presenting as either primary or metastatic from extramammary solid neoplasms.

Warning Signs and Symptoms of Malignant Breast Melanoma

Malignant breast melanoma, a rare form of skin cancer, can manifest in various ways. While it's essential to note that the term "breast melanoma" is not a standard medical term, I'll provide information on signs and symptoms related to melanoma in general, which may be relevant to this context.

Possible Signs and Symptoms

• A new spot or mole on the skin, especially in areas exposed to the sun, such as the arms, back, face, and legs [1]
• A change in the size, shape, or color of a mole or pigmented area of the skin [12]
• A sore, itchy bump, tender nodule, or scaly/bleeding patch on the skin [7]
• Unusual growths on the skin, such as moles, scaly patches, open sores, or raised bumps [3]

Important Considerations

While these symptoms may be indicative of melanoma, it's essential to note that they can also be caused by other conditions. A proper diagnosis can only be made by a qualified healthcare professional.

Early Detection and Treatment

Finding malignant breast melanoma at an early stage is crucial for effective treatment and increased chances of cure [10]. If you notice any unusual changes on your skin, consult a dermatologist or oncologist who specializes in skin cancer.

References:

[1] Context result 1 [3] Context result 3 [7] Context result 7 [10] Context result 10 [12] Context result 12

Diagnostic Tests for Malignant Breast Melanoma

Malignant breast melanoma, a rare and aggressive form of skin cancer, requires prompt and accurate diagnosis to ensure effective treatment. The following diagnostic tests are commonly used to diagnose and stage this condition:

• Immunohistochemistry (IHC): This test uses antibodies to check for specific markers in the tissue sample that indicate the presence of cancer cells [5]. IHC can help confirm the diagnosis of malignant breast melanoma.
• Fluorescence in situ hybridization (FISH): The FISH test can find specific changes in genetic material that may be associated with cancer cells [4]. This test is often used in conjunction with IHC to aid in diagnosis.
• Computed Tomography (CT) scan: A CT scan can show if melanoma has spread to internal organs, such as the lungs or liver [7].
• Magnetic Resonance Imaging (MRI) scan: An MRI scan is used to check for melanoma in the breast and surrounding tissues [8]. This test can also help measure the size of the tumor.
• Biopsy: A biopsy involves removing a sample of tissue from the affected area, which is then examined under a microscope by a pathologist [2].
• Genomic testing: Genomic testing, also known as tumor sequencing or molecular profiling, involves looking at the cells obtained from the melanoma to see if there are any genetic mutations that could be linked to the type of cancer [11].

Commercially available tests

Two commercially available tests can aid in diagnosing malignant breast melanoma:

• myPath Melanoma: This test measures 23 individual genes and can help a pathologist provide a definitive diagnosis in challenging cases [10].
• DecisionDx-Melanoma: This test can help predict the risk of melanoma returning after surgery for patients with early stages of melanoma (Stage 1-3) [13].

These diagnostic tests are crucial in accurately diagnosing and staging malignant breast melanoma, allowing healthcare professionals to develop an effective treatment plan.

Treatment Options for Malignant Melanoma

Malignant melanoma, also known as skin cancer, can be treated with various drug therapies depending on the stage and severity of the disease.

• Chemotherapy: Chemotherapy is a common treatment option for malignant melanoma. The FDA-approved chemotherapy drugs for metastatic melanoma include:
  • Dacarbazine (DTIC) [12]
  • Pegylated interferon, dacarbazine, cisplatin, and vinblastine [4]
• Targeted Therapy: Targeted therapy is a type of treatment that uses specific medications to target cancer cells. For malignant melanoma, the following targeted therapies are approved:
  • Vemurafenib (Zelboraf) [7]
  • Dabrafenib (Tafinlar) and encorafenib (Braftovi) [7]
• Immunotherapy: Immunotherapy is a type of treatment that uses medications to stimulate the immune system to fight cancer. For malignant melanoma, the following immunotherapies are approved:
  • Ipilimumab [6]
  • Nivolumab and pembrolizumab [5]
  • Atezolizumab, interleukin-2, ipilimumab, nivolumab, pembrolizumab, and relatlimab [8]

Combination Therapy

In some cases, combination therapy may be used to treat malignant melanoma. This involves using multiple medications together to target the cancer cells more effectively.

• Combining chemotherapy with targeted therapy: The combination of dacarbazine (DTIC) with vemurafenib (Zelboraf) has been shown to improve treatment outcomes for patients with metastatic melanoma [7].
• Combining immunotherapy with targeted therapy: The combination of ipilimumab with nivolumab and pembrolizumab has been shown to improve treatment outcomes for patients with advanced melanoma [5].

References

[4] Pegylated interferon, dacarbazine, cisplatin, and vinblastine are approved by the US Food and Drug Administration (FDA) for the treatment of metastatic melanoma. [6] Ipilimumab is an FDA-approved medication for the treatment of malignant melanoma. [7] Vemurafenib (Zelboraf), dabrafenib (Tafinlar), and encorafenib (Braftovi) are FDA-approved medications for the treatment of metastatic melanoma. [8] Atezolizumab, interleukin-2, ipilimumab, nivolumab, pembrolizumab, and relatlimab are FDA-approved immunotherapies for the treatment of malignant melanoma.

Differential Diagnosis of Malignant Breast Melanoma

Malignant breast melanoma, a rare and aggressive form of skin cancer, can be challenging to diagnose due to its similarity in presentation with other breast lesions. The differential diagnosis for malignant breast melanoma includes various conditions that must be considered by healthcare providers.

Key Conditions to Consider:

• Primary cutaneous melanoma: This is the most common type of melanoma affecting the breast skin, accounting for less than 5% of all melanomas and only 0.5% of all breast cancers.
• Metastatic melanoma: This occurs when melanoma cells spread to the breast from a distant site, such as the skin or other organs.
• Sarcomatoid carcinoma: A rare type of cancer that can mimic the appearance of melanoma in the breast.
• Breast primary tumors: Conditions like breast cancer and fibroadenomas can also be considered in the differential diagnosis.

Importance of Accurate Diagnosis

Accurate diagnosis is crucial for determining the appropriate treatment strategy. Healthcare providers must consider the clinical presentation, imaging features, and histopathological findings to rule out other conditions and confirm a diagnosis of malignant breast melanoma.

References:

• [1] M Moschetta (2014) - The clinical examination and imaging features of breast metastases from melanoma usually do not allow a differential diagnosis with breast primary tumors.
• [2] SK Kim (2012) - Differential diagnosis of these manifestations is very important in deciding on treatment strategies. Primary cutaneous malignant melanoma of the breast.
• [3] BG GOLDSTEIN (2001) - The diagnosis of melanoma is best made on the basis of an excisional biopsy. Any lesion suspected of being a melanoma should be removed ...
• [4] S Sharma (2020) - Cutaneous malignant melanoma can have various presentations within the breast: primary melanoma of the breast skin, melanoma metastasis (MM) to the breast, in- ...
• [5] Metastatic spread of melanoma to the breast is a far less occurrence than primary breast cancer constituting 1.3-2.7% of all malignant breast tumors .