How would you treat an axillary presentation of a breast cancer in the absence of a breast primary?

In the era of MRI these have become rare as sensitivity of MRI is high. Our approach is to treat breast and RNI with no mastectomy as reported LR is low with this approach

After appropriate search for primary (MRI, MBI - if available), if it is a truly an occult primary breast tumor, I treat breast and nodes. There is no evidence that mastectomy versus radiation improves control in older series, but emergence of primary without local therapy to the breast occurs in a ...