Breast metastasis from colorectal cancer treated by multimodal therapy

Abstract

Introduction: Breast metastases from primary colorectal carcinoma are extremely rare, with only 45 cases being reported previously. Since the most common malignancy in the breast and axilla is primary breast cancer regardless of cancer history, non-hematologic metastases may be misdiagnosed initially. Nevertheless, differentiating breast metastases from primary breast cancer is crucial because of their differences in prognosis and management. Patient concerns: We present a case of a 44-year-old Asian woman who noticed a new right breast lump after undergoing surgery and chemotherapy for her primary sigmoid colon cancer. Diagnosis: Image and immunohistochemistry findings were consistent with breast metastasis from primary colorectal adenocarcinoma. Interventions: The patient underwent breast tumor excision and reinitiated chemotherapy. Outcomes: The patient's disease progressed despite the interventions. She passed away 7 months after the detection of breast metastasis. Conclusion: When a new breast lesion is detected in patients with colorectal cancer history, the physician should consider the possibility of breast metastasis due to the poor prognosis. If a biopsy is necessary, cancer history should be provided to the clinicians to prevent incorrect pathological interpretation. In establishing the diagnosis, certain immunohistochemical markers have been shown to be sensitive and specific in previously reported cases. The combination of tumor excision and chemotherapy was the most common strategy in managing this condition with inconsistent clinical outcomes.

Breast Metastasis Of Signet Ring Cell Carcinoma From The Colon: A Case Report

“…We have lack experience in the treatment of patients with rare site metastasis. For now, a majority of the patients with breast metastasis form colon received standardized management of their primary tumor [21]. If the patients recur with solitary nodules within the breast, surgical excision with negative margins may bene t for them [22,23].…”

Colorectal cancer metastatic to the breast: A case report

“…A majority of these patients received standardized management of their primary CRC[ 3 ], even if according to a recent report, the management of metastatic breast mass from CRC is often diagnostic and palliative[ 1 ]. Oral capecitabine, which was prescribed as palliative chemotherapy, might further slow the growth of the patient's metastasis in the breast[ 10 ].…”

“…Breast metastases from other tumors are quite rare and account for only 0.5%-3% of all breast metastasis[ 1 , 2 ]. For colorectal cancer (CRC) metastatic to the breast, the differential diagnosis between rare non-mammary breast metastases and primary cancer is crucial because of the completely different approach in management and prognosis[ 3 ]. Patients with breast metastases from CRC generally have a poor prognosis, and the management is palliative.…”

A Rare Case of Metastatic Mucinous Breast Carcinoma as a First Presentation of Colon Cancer in a Male Patient: Case Report and Review of the Literature

“…The mean age at which breast metastases were detected was 52-year-old. Isolated breast metastases were found in 12 cases and in the majority of cases, breast metastases were diagnosed after a previous diagnosis of colorectal cancer [4,5]. Zhang et al reported one case in which the initial presentation was a breast lesion in an 80-year-old female patient with the primary sigmoid tumor that was identified later [6].…”

“…This is reasonable if the lump is mistaken for as primary breast cancer or becomes symptomatic as in our case. Unfortunately, the prognosis of patients with metastatic breast tumor of colorectal cancer origin is worse than the general colorectal cancer patients with distant metastases, with a 5-year survival rate of 13.8% due to the highly aggressive nature of breast metastasis from colorectal cancer [4].…”