3rd ESO–ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 3)

Metastasis to the pancreas and stomach from a breast cancer primary: a case report

“…This is a better prognosis compared to the average 5-year survival rates of primary gastric and pancreatic adenocarcinomas, which stand at 31% and 8% respectively [16]. Once there are distant metastases, typical invasive ductal adenocarcinoma of the breast becomes largely incurable and 5-year survivability drops by more than half to roughly 25% [17]. However, the few patients with invasive ductal adenocarcinoma that have metastasized to the pancreas had a survivability that ranged between 1 and 50 months [13].…”

“…There are reports that surgical resection of an isolated metastatic tumour of the pancreas can improve survivability and should be first-choice treatment, whereas other authors favor initial systemic therapy due to the significant morbidity and mortality associated with pancreaticoduodenectomy [4,13]. In both cases, surgical resection of the metastasis can be a useful means to palliate symptoms and improve quality of life [17]. …”

“…Regardless of the site of metastasis, initial systemic therapy is the recommended standard of care for stage IV breast cancer [17]. Dual blockade of HER2/neu receptors in combination with chemotherapy has been shown to provide substantial survival benefit, hence the initiation of pertuzumab, trastuzumab, and docetaxel in this patient [17].…”

“…Dual blockade of HER2/neu receptors in combination with chemotherapy has been shown to provide substantial survival benefit, hence the initiation of pertuzumab, trastuzumab, and docetaxel in this patient [17]. Hormonal therapy is also recommended in the management of ER positive tumours, and was eventually added to the patient’s treatment regimen [17].…”

“…Dual blockade of HER2/neu receptors in combination with chemotherapy has been shown to provide substantial survival benefit, hence the initiation of pertuzumab, trastuzumab, and docetaxel in this patient [17]. Hormonal therapy is also recommended in the management of ER positive tumours, and was eventually added to the patient’s treatment regimen [17]. Targeted therapy against HER2/neu receptors has shown a large improvement in triple positive breast cancer survival, and could easily have been delayed in this case had she not received a screening mammography when she did [17].…”