Breast cancer metastasis to the stomach

Abstract

Aim: This study focuses on the stomach as an unusual but not rare site of metastasis of breast cancer. Methods: We performed a literature search on gastric metastasis from breast cancer searching for reviews from 2000 to 2018 and case reports from 2013 to 2018. We found 11 reviews and 36 case reports and we compared their findings about important aspects of gastric metastasis, such as disease free survival, overall survival, symptoms, endoscopic findings, therapy, histology, and immunohistochemistry. Results: The incidence of stomach as site of metastasis of breast cancer ranges from 5% to 18%. Reviews and case reports reached similar conclusions about several of the aforementioned aspects: invasive lobular breast cancer (ILC) is mainly responsible for gastric metastases; disease free survival can vary greatly ranging from 0.5 months to 30 years; gastric metastases usually present with non-specific symptoms, even though five patients in case reports were asymptomatic; linitis plastica is the most common endoscopic finding; immunohistochemistry is essential for differentiating primary gastric cancer from metastasis; the preferred treatment is systemic therapy, but surgery is still an option in case of emergency; median overall survival of patients with gastric metastasis from breast cancer is 24 months. Conclusion: Breast metastasis to the stomach should be considered in any patient suspecting gastric neoplasm previously treated for breast carcinoma, especially if the treated carcinoma was ILC.

Atypical Presentation of Breast Cancer Metastasis to the Bowel: A Case Report

“…The reported median interval between breast cancer diagnosis and presentation with intestinal metastasis is variable. D'Angelo et al and McLemore et al reported five and seven years, respectively, in different studies [6,7]. Our patient, in contrast, presented two years after diagnosis, although she had a late-stage disease at diagnosis.…”

Hereditary breast cancer: syndromes, tumour pathology and molecular testing

“…However, even without a family history of gastric cancer, patients with HLBC have a markedly elevated risk of developing occult gastric malignancy 79 . Breast cancer metastasis may need to be excluded in patients with diffuse gastric cancer who also have a history of ILC, as ILC is the most common breast cancer subtype to metastasise to the stomach and morphologically mimics diffuse‐type gastric cancer 80 . Differentiating metastatic breast from primary gastric carcinoma requires a panel of immunohistochemical markers; for example, GATA binding protein 3 (GATA3), oestrogen receptor (ER) and progesterone receptor (PR) positivity supports breast origin, while CK20 and CDX2 positivity is seen in a proportion of gastric carcinomas 81,82 …”

The Stomach: An Uncommon Site for Metastatic Breast Cancer

“…Though our patient presented with metastatic ILC to the stomach on first presentation, there have been multiple reports describing metastatic breast cancer to the stomach manifesting years after the initially surgical treatment of breast cancer with disease-free intervals ranging from a few months to up to 30 years [9]. In summary, with its higher propensity for gastrointestinal spread, a high index of suspicion should be present in patients with ILC.…”