Cutaneous Metastases from Breast Carcinomas: A 10-year Retrospective Analysis at a Single Institution

Summary: Objective: Cutaneous metastasis (CM) from breast carcinoma (BRCA) is a rare but significant manifestation of metastatic disease, affecting approximately 30% of patients with CM. This study aims to identify clinicopathological factors influencing survival outcomes in BRCA patients with CM, based on a 10-year retrospective review (1990-2024). Methods: We conducted a retrospective clinicopathologic review of 92 BRCA patients with CM at our institution. Clinicopathological data were analyzed using univariate and multivariable Cox regression models to identify predictors of overall survival (OS), cutaneous metastasis-free survival (CMFS), and cutaneous metastasis-specific survival (CMSS). Results: The median age of patients was 55 years, with a median follow-up of 95 months. CM most commonly affected the trunk (87%) and presented as nodules (71%). Phenotypic changes were observed in 49% of cases. Significant predictors of poor OS included carcinoma en cuirasse presentation (p=0.0048), skin as the initial BRCA diagnosis (p=0.0047), and metastasis location (CM alone vs. CM with nodal/distant metastasis) (p=0.00044). Larger tumor size (p=0.0007), higher histologic grade (p=0.0075), and triple-negative CM (p=0.00038) were also associated with poor survival. For CMFS, age (p=0.021), tumor size (p=0.00069), histologic grade (p=0.001), and surgery (p<0.0001) were significant predictors. In CMSS, carcinoma en cuirasse presentation (p=0.0058), metastatic location (p=0.0011), and triple-negative CM (p=0.00033) were key factors. Multivariable analyses identified carcinoma en cuirasse (p=0.031), hormonal therapy (p=0.008), and metastasis location (p<0.001) as significant OS predictors, while surgery and tumor size were critical for CMFS. Conclusion: Carcinoma en cuirasse presentation is an independent predictor of poor overall and CM-specific survival in BRCA patients. Larger tumor size, receptor status, and metastatic location are also critical prognostic factors, underscoring the importance of early detection and targeted therapies in improving outcomes for patients with cutaneous metastasis from breast carcinoma.