What is your approach to initial management of patient with clinically palpable axillary disease, histologically proven breast cancer, with no imaging evidence of an occult primary or metastatic disease?

The frequency of TXN+M0 cases has declined with the availability of breast MRI, as many cancers occult on mammography and ultrasound are detected by MRI, but they still occur, and are usually high grade, triple-negative or HER2+. I treat these as I would any patient with node-positive disease, with ...

I had a similar case; no breast primary on mammo, breast us and mri. I ended up doing a PET-CT and found a small signal in the ipsilateral breast. We did a biopsy (w/marker placement) that identified the primary breast lesion (TNBC, IDC). Anyways, I am currently doing neoadjuvant chemo.