This site is demonstrated in comparative studies of normal breasts and cancer-bearing breasts obtained at autopsy and from cancer-bearing lumpectomy or mastectomy specimens [ 18, 19, 23].
Of the 85 cases in total, 28 were thought clinically to have died as a result of breast carcinoma but autopsy confirmed these findings in only 21 (75%).
The concept of the first site of distant metastasis is not well-defined, because at autopsy breast cancer metastases can be found in many organs [ 34], and likely more metastatic sites are found at the time of detection of the first metastases the closer the patient is examined.
The most thorough histopathological study of breasts obtained at autopsy in Denmark examined an average of 275 paraffin blocks per breast: for women between the ages of 40 to 50 years not known to suffer from breast cancer when alive: 39 % were found to have ductal carcimonas in situ and another 12%% had atypical ductal hyperplasia [ 65].
Visualisation of duct anatomy in the nipple and the mammary corpus in medical-legal autopsy breasts is proposed with appropriate consent.
OncoCarta analysis identified mutations in the brain metastases from primary breast cancers (non-autopsy cases) in NRAS (2/12 - 17%), and PIK3CA (2/12 - 17%) (Table 1 and Figure 3).
For comparison, one normal breast tissue from an autopsy was included in the first lane; it was BP1-negative.
Furthermore, analyses of breast tissue from human autopsy and surgical specimens suggest that additional morphologic changes in the epithelium repeatedly occur during each menstrual cycle [ 5].
It is well known that among metastatic liver cancers, primary tumors were predominantly from the lung, colon, pancreas, breast, and stomach in autopsy series [ 40].
See related editorial by Grewal and Kesari, Brain metastases (BM) clinically present in up to 16% of all metastatic breast cancers (MBC), although autopsy series reveal approximately twice as many cases (34%) [ 1, 2].
