Gastric Metastasis of Breast Cancer: A Case Series

Fernandes, Gustavo dos Santos; Faria, Luiza Dib Batista Bugiato; Pereira, Isadora de Assis; Neves, Natália C. Moreira; Vieira, Yasmine Oliveira; Leal, Alessandro

doi:10.4081/rt.2016.6305

Cited by 9 publications

(4 citation statements)

References 7 publications

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“…Outcomes for patients who have gastric metastasis of breast cancer are poor, averaging 24-month survival after the diagnosis of gastric metastasis [ 5 , 11 ]. However, with recent increased treatment options, survival of patients with MBC is expected to be prolonged.…”

Section: Discussionmentioning

confidence: 99%

A Gastric Metastatic Lesion That Resembled Early-Stage Gastric Cancer on Endoscopy during Treatment for Recurrent Breast Cancer: A Case Report

et al. 2021

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Breast cancer metastasis to the gastrointestinal tract is relatively rare. Patients with such disease often develop gastrointestinal symptoms, but it is sometimes asymptomatic. Endoscopic findings of gastric metastasis from breast cancer markedly vary from benign to malignant, and even in suspected malignant cases, it is often difficult to differentiate between primary and metastatic disease. We experienced a case in which an endoscopic examination performed during the treatment for metastatic breast cancer resembled an early-stage gastric cancer. A 71-year-old woman underwent curative surgery for right breast cancer 16 years previously. She underwent endoscopic submucosal dissection for early-stage gastric cancer 5 years ago. Two years ago, she developed metastatic disease in the lungs and mediastinal lymph nodes, and endocrine therapy was administered. At the same time, a follow-up endoscopy revealed a new elevated lesion, suspected to be an early-stage gastric cancer. However, histological diagnosis of the biopsy was metastasis of breast cancer. One and a half years later, a follow-up endoscopy revealed a gastric lesion that had reduced in size. She is still alive, having received a variety of systemic treatments. Patients with metastatic breast cancer are experiencing prolonged survival. Thus, follow-up endoscopy should be considered after the diagnosis of gastrointestinal metastasis considering the risk of lethal conditions, such as gastrointestinal bleeding and perforation. Our case serves as a reminder to clinicians how difficult it is to determine whether a gastric lesion is primary or metastatic based on endoscopic findings and the importance of communication with endoscopists and pathologists.

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Section: Discussionmentioning

confidence: 99%

A Gastric Metastatic Lesion That Resembled Early-Stage Gastric Cancer on Endoscopy during Treatment for Recurrent Breast Cancer: A Case Report

et al. 2021

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“…In 45 cases immunohystological study of the biopsies from gastric lesions or gastric wall were taken before starting any treatment; considering patients who underwent gastrectomy, nine [23,26,27,28,35,42,43,45] were taken after surgical treatment whereas three [23,28,43] were done before, but authors decided to perform surgery because they suspected primary gastric cancer or they couldn't exclude it.…”

Section: Gastric Tumor/receptormentioning

confidence: 99%

“…Combination of surgery and chemotherapy was used in 10 patients [23,28,29,35,[37][38][39]41,43,45] ; two of them [28,29] were submitted to neoadjuvant chemotherapy followed by surgery in the belief of a primary gastric cancer. Surgical treatment alone was chosen in 7 [26,27,42] patients, with three [27,42] of them in an emergency setting for bleeding and perforation. Endoscopic stenting for obstruction was used successfully in 2 patients [19,22] .…”

Section: Therapymentioning

confidence: 99%

“…Systemic therapy is the treatment of choice in the reviews and even in case reports (used in 41 patients). Surgery is usually performed in case of complications such as perforation or bleeding; in three cases patients were submitted to emergency laparotomy, two [28] for perforation and septic shock and one [42] for bleeding and hemorrhagic shock. Main surgical intervention is gastrectomy (performed in 13 patients), whereas in one patient [41] only raffia and biopsy were performed in the setting of a perforation.…”

Section: Part 3 Comparison Between Reviews and Case Reportsmentioning

confidence: 99%

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Breast cancer metastasis to the stomach

D’Angelo¹,

Rampini²,

Cardella³

et al. 2019

JCMT

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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.

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