Infiltrating Lobular Carcinoma of the Breast Presenting as Gastrointestinal Obstruction: A Mini Review

Abstract

One in twelve American women will develop breast cancer, with infiltrating lobular carcinoma (ILC) comprising approximately 15% of these cases. The incidence of ILC has been increasing over the last several decades. It has been hypothesized that this increase is associated with combined replacement hormonal therapy. Although pathologically distinct from infiltrating ductal carcinoma (IDC), ILC is treated in the same manner as IDC. However, ILC demonstrates significantly different patterns of late local recurrence and distant metastasis. The incidence of extra-hepatic gastrointestinal metastases is reported to be 6% to 18%, with stomach being most common. Herein, we present a brief review of the literature and a typical case involving ILC initially presenting as a small bowel obstruction. Evidence suggests that the late clinical patterns of ILC are distinctly separate from IDC and physicians need be cognizant of its late local recurrence and unique late metastatic pattern. Different follow up strategy should be entertained in patients with ILC.

Synchronous Orbital and Gastrointestinal Metastases from Breast Cancer: A Case Report and Review of Literature

“…According to 2012 GLOBOCAN estimates, there were nearly 1.7 million new cases of breast cancer diagnosed worldwide [ 22 ] and this figure is expected to rise to 2.1 million by 2030 [ 1 ]. Extrahepatic gastrointestinal metastases are rare with the stomach reported as the most common site involved, followed by the small intestine and colon [ 3 , 17 , 23 ]. Several large studies have reported that less than 1% of patients with metastatic breast cancer have GI involvement [ 13 , 16 , 17 ].…”

“…Radiotherapy and palliative surgery (resection, GI bypasses, and debulking of metastatic disease) can be used in selected patients [ 13 ]. Some authors have also advocated closer GI follow-up for patients diagnosed with ILC [ 3 , 34 ]. In a recent review article looking at patients with MBC affecting the GI tract, Ambroggi et al [ 17 ] reported that the median overall survival is 16 months with a range of 5–41 months.…”

“…Histologically, there are two main subtypes of breast cancer: invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC). Invasive lobular carcinoma comprises approximately 10% to 15% of these cases and it is reported that its incidence has been increasing over the last several decades, especially in postmenopausal women [ 3 – 5 ]. ILCs have a distinctive growth pattern which can sometimes lead to vague findings on clinical breast examination making it difficult to diagnose; they fail to form palpable discrete nodules like IDC tumours [ 6 ].…”

Gastrointestinal Metastases of Breast Cancer: Report of Two Cases and Review of the Literature

“…In our review the incidence of gastrointestinal metastases from breast cancer is 0.08% which is close to the data collected in the literature. Ductal breast cancer is the prevalent type, whereas lobular subtype appears in approximately 35%, being more frequent bilateral and multicentric [6] . Both subtypes seem to have a different metastatic pattern.…”

Large Bowel Obstruction Subsequent to Resected Lobular Breast Carcinoma: An Unconventional Etiology of Malignant Obstruction

“…Interval between primary diagnosis and GI metastasis varies widely with an average of seven years but range of 0–30 years [ 5 , 8 , 9 ]. Metastasis can also occur synchronously with primary diagnosis [ 9 – 11 ]. Such variance presents a diagnostic challenge, particularly regarding timing and extent of metastatic workup in setting of nonspecific GI complaints.…”