Gastric Metastasis Of Breast Cancer Research Articles

Gastric metastasis from breast cancer: five cases and a single-institutional review.

Gastric metastasis from breast cancer has a high rate of misdiagnosis and missed diagnosis. Data of patients who had gastric metastasis from breast cancer were retrieved from our hospital between 2014 and 2020. The gastric metastasis from breast cancer incidence was 0.04% (5/14,169 cases of breast cancer). Four patients had invasive lobular carcinoma, and the other patient had invasive ductal carcinoma. The time from the initial diagnosis of breast cancer to the appearance of gastric metastasis ranged from 0 to 12 years. One patient's endoscopic presentation was similar to mucosal-associated lymphoid tissue lymphoma and presented with gastric mucosal congestion and edema, widened wrinkles, mixed color fading, and redness. The initial pathological diagnosis of this patient was mucosal-associated lymphoid tissue lymphoma, and breast cancer was finally confirmed by immunohistochemistry. Hormonal receptors were highly expressed in four patients with primary and metastasis lesions and were negative in one patient. Human epidermal growth factor receptor 2 was negative in all patients. Mammaglobin and GATA3 were positive in all patients. In conclusion, the gastric metastasis of breast cancer incidence rate is low, and misdiagnosis can lead to insufficient or excessive treatment. Multiple biopsies and immunohistochemistry should be performed to diagnose gastric metastasis of breast cancer.

Gastric metastasis of breast cancer: A frequent mimicker of primary gastric cancer in breast cancer patients.

Gastric metastasis of breast cancer is a known mimicker of primary gastric cancer. This paper demonstrates that in patients with a history of breast cancer, gastric metastasis and primary gastric cancer are equally likely.

S3656 Primary Diagnosis of Metastatic Breast Cancer via Esophagogastroduodenoscopy With Gastric Biopsies

Introduction: Gastric metastases are a rare manifestation of breast cancer and previous case reports suggest they typically occur in patients with a long standing history of breast cancer. We present a case of a patient whose primary diagnosis of breast cancer was made via gastric biopsies taken during esophagogastroduodenoscopy (EGD) after the patient presented to the hospital with symptoms of persistent nausea and vomiting. Case Description/Methods: The patient is a 58-year-old female with a reported history of alcohol use disorder who presented to the emergency department with intractable nausea and vomiting. On arrival, the patient’s vitals were stable and labs were only significant for a mildly elevated creatinine of 1.40, which normalized with IV fluids. Computed tomography (CT) of the abdomen and pelvis showed diffuse gastric wall thickening. Following the results of the CT, an EGD was performed which revealed diffuse gastritis with friable mucosa and concern for malignancy or ischemia. Gastric biopsies were suggestive of adenocarcinoma with likely primary being breast cancer. Immunohistochemical staining was positive for CDK7, GATA3, mammaglobin, and 80-90% estrogen receptor. Following consideration of both the pathologic appearance and immunohistochemical staining, the diagnosis was made of metastatic lobular carcinoma. Due to the patient's poor support system and functional status, the patient elected to pursue hospice, and therefore further workup was not performed (Figure 1). Discussion: Breast cancer is the second most common malignancy in women in the United States, with metastasis of breast cancer classically spreading to lungs, liver, bone, soft tissue, and adrenal glands. Metastasis to the gastrointestinal (GI) tract is rare, with lobular breast cancer having higher predilection over ductal carcinoma. The average time for breast cancer to metastasize to GI tract has been previously reported as many years after primary diagnosis. Here we present a case of breast cancer where the primary diagnosis was made after EGD assisted gastric biopsies. After extensive literature review, there is sparse information on early gastric metastasis of breast cancer. While our patient's previous history of breast cancer screening is unknown, she had no prior knowledge of her breast cancer diagnosis. This case signifies the importance of endoscopic evaluation and gastric biopsies in patients with nonspecific symptoms, especially with abnormal imaging findings suggestive of gastritis.Figure 1.: Endoscopic appearance of the gastric mucosa.

S3168 Metastatic Breast Cancer to a J-Shaped Muscular Bag – The Stomach

Introduction: Female breast cancer was the leading cause of global cancer incidence in 2020, with an estimated 2.3 million new cases, representing 11.7% of all cancer cases. The most common primary target sites of breast cancer metastasis are bone, lung, liver, and brain. The stomach is an infrequent site of breast cancer metastasis, accounting for an incidence ranging from 0.3% in retrospective studies to 8-18% in autopsy series. Needless to say, metastasis to the stomach from any primary tumor is itself atypical, with an incidence of 0.2-1.7%. We present a case of breast cancer metastasis to the stomach from a rare histological subtype of breast cancer- glycogen-rich, clear cell breast carcinoma. Case Description/Methods: 75- year-old female with clear cell glycogen rich invasive carcinoma, stage IIIB of the right breast presented to the emergency department (ED) complaining of fatigue and weakness for two days. Vital signs were normal. Physical examination revealed ataxic gait and right-sided hemiparesis. Labs showed a hemoglobin of 7.5 g/dl (baseline 9.8 g/dl) and hematocrit 23.5% (baseline 30%). The following day her hemoglobin asymptomatically dropped to 6.8 g/dl, and a repeat reading showed a further decline to 5.8 g/dl. Two units of packed red blood cells (PRBC) were transfused, which increased her hemoglobin to 7.8 g/dl. Fecal Occult Blood Test (FOBT) was positive, and gastroenterology was consulted to investigate further. Computerized Tomography (CT) of the abdomen showed a 4.4 cm intraperitoneal mass in the left mid-abdomen highly suggestive of metastasis. Esophagogastroduodenoscopy (EGD) revealed several gastric ulcers on the greater aspect of the stomach's body located on the mucosal mound or raised mucosa (Figure 1). Given the undermining margins and the ulcer's location, there was increased suspicion for malignancy and she was diagnosed with metastatic poorly differentiated gastric adenocarcinoma. Due to the patient's low-performance status, hospice/palliative care was pursued. Discussion: The exact mechanism of gastric metastasis of breast cancer is still unclear. Gastric metastasis can have a negative impact on survival and must be investigated in patients with breast cancer who present with non-specific gastrointestinal symptoms. There should be a very high index of suspicion for a prompt diagnosis. In patients with a history of breast cancer, gastric endoscopy should be offered in cases of GI symptoms, even when the symptoms are vague.Figure 1.: Gastric perforation secondary to malignant gastric outlet obstruction.

Keep scalpel sheathed: A metastatic invasive ductal carcinoma mimics primary linitis plastica

Though differentiating gastric metastasis of breast cancer from primary gastric cancer is challenging, it is of paramount importance because the treatments to these two diseases are completely different. A wrong diagnosis could lead the patient to unnecessary gastrectomy. It is more challenging for gastric metastasis of invasive ductal carcinoma given its rarity. Here we reported a case whose diagnosis was made correctly with complementary lab studies, clinically well‐informed Pathologist and special immunohistochemical staining. Correct diagnosis and following treatment saved the patient from gastrectomy and prolonged her survival.

Gastric Metastasis of Invasive Lobular Breast Carcinoma, a Current Diagnostic and Treatment Challenge - A Review.

Introduction: The predilection of lobular invasive breast cancer metastasis for the stomach is a topic that has succumbed to various assumptions over the time. Background and Aims: Gastric metastasis of lobular breast cancer is unusual and it can be diagnosed after a long period of time from primary tumor diagnosis. The aim of this study was to review current knowledge regarding the current methods of diagnosis and treatment of gastric metastasis of breast cancer. Methods: A systematic literature search was performed in the Pub-Med Medline database using the terms "gastric metastasis of lobular breast cancer" and "gastric metastasis features" to identify articles relevant to gastric metastasis of lobular breast cancer. Results: Several papers have shown that the topic is rarely presented in the form of case presentations or miniseries by summing up sporadic cases. Due to its rarity and metastasis specificity as host type and appearance after latency of lobular breast cancer makes its gastric metastasis considered atypical and occasionally confused with a primary stomach malignancy. The most recent articles present the immunohistochemical diagnostic criteria of this clinical entity and a new therapeutic approach. Conclusion: At patients with gastric metastasis of lobular breast cancer, obtaining pathologic material and biopsies interpretation can be a real challenge for getting a correct pathologic diagnosis, immunohistochemistry gives us definite diagnosis. The introduction of an endoscopic surveillance protocol for patients with lobular breast cancer could be a proposal for the detection of early gastric metastases allowing for appropriate therapy.

BREAST CANCER METASTASIS IN THE STOMACH: WHEN THE GASTRECTOMY IS INDICATED ?

ABSTRACTBackground:Breast cancer is the most common malignant neoplasm in the female population. However, stomach is a rare site for metastasis, and can show up many years after initial diagnosis and treatment of the primary tumor. Aim:Analyze a case series of this tumor and propose measures that can diagnose it with more precocity. Methods:Were analyzed 12 patients with secondary gastric tumors. Immunohistochemistry has demonstrated that primary tumor was breast cancer. We retrieved information of age, histological type, interval between diagnosis of the primary breast cancer and its metastases, immunohistochemistry results, treatment and survival. Results:The mean age was 71.3 years (ranging 40-86). Ten cases had already been underwent mastectomy in the moment of the diagnosis of gastric metastasis. Two patients had diagnosis of both primary and secondary tumors concomitantly. At average, diagnosis of gastric metastasis was seven years after diagnosis of primary breast cancer (ranging 0-13). Besides, nine cases had also metastases in other organs, being bones the most affected ones. Immunohistochemistry of the metastases has shown positivity for CK7 antibody in 83.34%, estrogen receptor in 91.67%, progesterone receptor in 66.67% and AE1AE3 antibody in 75%, considering all 12 cases. Moreover, CK20 was absent significantly (66.67%). The positivity of BRST2 marker did not present statistical significance (41.67%). Eight cases were treated with chemotherapy associated or not with hormonal blockade. Surgical treatment of gastric metastasis was performed in four cases: three of them with total gastrectomy and one with distal gastrectomy. Follow-up has shown a mean survival of 14.58 months after diagnosis of metastasis, with only two patients still alive. Conclusion:Patients with a history of breast cancer presenting endoscopic diagnosis of gastric cancer it is necessary to consider the possibility of gastric metastasis of breast cancer. The confirmation is by immunohistochemistry and gastrectomy should be oriented in the absence of other secondary involvement and control of the primary lesion.

Gastric metastasis of ectopic breast cancer mimicking axillary metastasis of primary gastric cancer.

Ectopic breast tissue has the ability to undergo all the pathological changes of the normal breast, including breast cancer. Gastrointestinal metastasis of breast cancer is rarely observed and it is very difficult to differentiate gastric metastases from primary gastric cancer. We present a case of 52-year-old female, who suffered from abdominal pain. Physical examination showed a palpable mass in the left anterior axilla and computerized tomography revealed gastric wall thickening with linitis plastica. When gastroscopic biopsy showed no signs of malignancy, excisional biopsy was performed in the left axilla. Histological examination revealed invasive lobular carcinoma of the breast, consistent with ectopic breast cancer. Further gastroscopic submucosal biopsies and immunohistochemical studies revealed gastric metastases of invasive lobular carcinoma. Axillary ectopic breast tissue carcinomas can mimic axillary lymphadenopathies. Additionally, gastric metastasis of breast cancer is an uncommon but possible condition. To the best of our knowledge, this is the first report of ectopic breast cancer with gastric metastasis.

Gastric metastasis of breast cancer mimicking primary gastric cancer: A case report

Gastric metastasis of breast cancer mimicking primary gastric cancer: A case report

Gastric metastasis of breast cancer: A single centre retrospective study

Background Digestive metastasis of breast cancer are rare but when they do occur the stomach is one of the commoner sites. Aim To describe the clinical, endoscopic, pathological features and treatment. Methods 35 cases of gastric metastasis were identified retrospectively between 1980 and 2008. Results The location of the gastric metastasis was fundus ( n = 15, 43%), antrum ( n = 15, 43%) or both ( n = 5, 14%). The histological subtype of primary breast cancer was invasive lobular carcinoma in 34 patients (97%). Hormonal receptors were positive in 19 out of 24 cases (79%), two out of 22 analysed were HER2 positive (9%). There were 16 (46%) patients with peritoneal carcinosis. The treatment was chemotherapy ( n = 13, 37%), hormonotherapy ( n = 2, 6%) or both ( n = 13, 37%). The 2-year survival rate after gastric metastasis diagnosis was 53% with a median follow up of 31 months [7–84 months]. Conclusion Ninety-seven percent of gastric metastasis from breast cancers are derived from invasive lobular carcinoma. Seventy-nine percent of these are HER+ and comparison with the original histopathological slides of primary breast carcinoma should be performed to differentiate gastric metastasis from primary gastric carcinoma. Peritoneal carcinomatosis accompanied gastric metastasis in almost half the cases in this series and treatment was generally chemotherapy.

Gastric Metastasis of Breast Cancer in a Male Patient: Report of a Case

A 65-year-old male patient presented with epigastralgia. At 57 years of age, the patient was diagnosed as cancer of the right breast (T1cN0M0) and underwent a mastectomy and axillary dissection. ER and PgR were positive, and HER2 was 2+. At six years after surgery, multiple metastatic lung tumors were found to have developed, and the patient underwent a partial resection of the left lung. Supraclavicular and mediastinal lymph nodes and pleural metastasis also developed postoperatively and were treated with chemotherapy. The patient developed epigastralgia at 30 months after the lung surgery, and underwent upper gastrointestinal endoscopy. An elevated lesion with a bridging fold was detected in the middle body of the stomach, and the results of a biopsy showed adenocarcinoma. The immunohistochemical staining results were positive for cytokeratin (CK) 7 and negative for CK20, and the patient was diagnosed as breast cancer metastasis to the stomach. Although breast cancer metastasis to the stomach has been detected in a small percentage of cases based on autopsy findings, it is extremely rare that a diagnosis of this disease is made in the clinical setting. A case of breast cancer metastasis to the stomach in a male patient is even rarer. A search of the Japan Centra Revuo Medicina database revealed only one such case among previous reports in Japan. In conclusion, it is necessary to address the possibility of breast cancer metastasis to the stomach when searching for a gastric tumor in a patient with a past history of breast cancer.

Gastric Metastasis of Ductal Breast Cancer – a Diagnostic Challenge

Purpose: 1. Consider breast cancer (BRCA) metastases in BRCA patients with an apparent primary gastric cancer 2. Recognize the importance of histopathologic and immunohistochemical analysis in diagnosis of BRCA metastases to stomach Methods: A 48 year old female was evaluated for burning epigastric discomfort of several months' duration. Medical history was remarkable for gastroesophageal reflux disease (GERD) resistant to proton pump inhibitors and 6-year history of metastatic BRCA status post surgery and chemotherapy. Biopsy of red, ulcerated lesion on gastric mucosa suspicious for gastric carcinoma revealed epithelial cells consistent with ductal BRCA. Patient was diagnosed to have gastric metastases from BRCA and referred to her oncologist for further management. Results: Gastric metastases have been reported in 2–18% of cases of BRCA. The median time interval between diagnosis of BRCA and occurrence of gastric metastases is about 5 years (2–30 years). The clinical presentation of BRCA metastases is often indistinguishable from primary gastric cancer due to non-specific symptoms. Majority of cases (83%) are due to invasive lobular BRCA, rest are from ductal cancer. Linitis plastica (most common), discrete nodules and external compression patterns are seen on gross pathology. BRCA metastases and primary gastric cancer are indistinguishable by gross endoscopic findings or radiography. Definitive diagnosis requires endoscopy-guided deep and extensive biopsies of suspicious lesions followed by histologic comparison with primary BRCA specimen. However, lobular BRCA may produce a signet ring morphology which may be confused with primary signet ring or diffuse-type gastric adenocarcinoma. Detailed immunohistochemical analysis will differentiate metastatic BRCA from primary gastric carcinoma in such cases. The absence of E-cadherin (seen in gastric cancer), the presence of ER-alpha (estrogen receptor alpha) receptors and positive monoclonal staining with GCDFP-15 (gross cystic disease fluid protein-15 – a protein found in breast cyst fluid and in plasma of patients with BRCA) support the diagnosis of BRCA metastases. Hormonal/chemotherapy are mainstay of treatment. Conclusion: Gastric metastasis of BRCA should be considered in BRCA patients with suspicious looking gastric lesions. This condition may be missed due to clinical presentation and similarity of histology with primary gastric cancer. Immunohistopathology is essential to guide proper diagnosis of BRCA metastases and avoid unnecessary surgery

A case of gastric metastasis of breast cancer

A case of gastric metastasis of breast cancer

Use of GCDFP-15 (BRST-2) as a Specific Immunocytochemical Marker for Diagnosis of Gastric Metastasis of Breast Carcinoma.

Metastasis of breast cancer to the stomach is relatively uncommon and typically occurs in patients with disseminated diseases. This may cause difficulty in differentiating it from primary gastric carcinoma. The correct diagnosis of the primary source is important, since the treatment and prognosis of metastatic breast cancer is quite different from those of metastatic gastric cancer. Immunohistochemical staining with GCDFP-15 (gross cystic disease fluid protein-15) can be used to differentiate primary gastric carcinoma and gastric metastasis from breast cancer. We report two cases of gastric metastasis of breast cancer by describing their clinical course, illustrating the histologic findings, and showing the results of immunohistochemical staining with GCDFP-15.