Metastatic Breast Cancer to the Stomach Resembling Early Gastric Cancer

Hara, Fumikata; Kiyoto, Sachiko; Takabatake, Daisuke; Takashima, S; Aogi, Kenjiro; Ohsumi, Shozo; Teramoto, Norihiro; Nishimura, Rieko; Takashima, Shigemitsu

doi:10.1159/000313923

Cited by 13 publications

(12 citation statements)

References 12 publications

(16 reference statements)

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“…Incipient gastric lesions are most commonly referred to as primary gastric cancers. A case that was diagnosed as early gastric cancer discovered gastric metastasis of breast cancer using endoscopic biopsies (32), and another case revealed that definitive diagnosis of metastatic breast cancer was confirmed after endoscopic mucosal resection of a presumed primary early gastric carcinoma (33).…”

Section: Diagnosticmentioning

confidence: 99%

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

Bîrlă¹,

Dinu²,

Iosif³

et al. 2019

chr

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patologic corect, imunohistochimia ne oferă un diagnostic de certitudine. Introducerea unui protocol de supraveghere endoscopică pentru pacienţii cu cancer lobular de sân ar putea fi o propunere pentru detectarea precoce a metastazelor gastrice care să permită o terapie adecvată.Cuvinte cheie: metastaze gastrice, cancer de sân lobular, teste imunohistochimice, endoscopie superioară Abstract 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.

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Section: Diagnosticmentioning

confidence: 99%

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

Bîrlă¹,

Dinu²,

Iosif³

et al. 2019

chr

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“…Some authors report an average time between primary tumor diagnoses and metastasis to the stomach ranging from 4 to 10 years 3,6, . The mean age of these metastatic tumors is predominantly in the perimenopausal period due to hormonal imbalances typical of this phase 10 .…”

Section: Discussionmentioning

confidence: 99%

“…The CK7 monoclonal antibody is present in tumors with glandular pattern, being observed at a maximum rate of 90% of breast cancers. It suggests breast cancer metastasis considering that only 50-64% of adenocarcinomas of the stomach present this molecule 8 , 10 , 11 . On the other hand, CK20 antibody presence favors the diagnoses of primary cancers from stomach, large bowel and pancreas 7 , 10 , 13 , 15 , 19 .…”

Section: Discussionmentioning

confidence: 99%

Breast Cancer Metastasis in the Stomach: When the Gastrectomy Is Indicated ?

Rodrigues

Tercioti-Júnior

Lopes

et al. 2016

ABCD, arq. bras. cir. dig.

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Background: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.

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“…[13] To be able to distinguish between gastric metastasis of breast cancer and primary gastric cancer, pathological and immunohistochemical analysis is recommended. [14] Histological features should be compared with those of primary breast cancer to confirm the diagnosis. GATA3 expression is most frequently observed in breast and urothelial carcinomas, and 91% of breast invasive ductal carcinomas exhibit GATA3 expression as evidenced by immunohistochemical analysis.…”

Section: Discussionmentioning

confidence: 99%

Aggressive recurrence of early breast invasive ductal carcinoma with gastric metastasis during adjuvant hormonal therapy

Shigematsu

Araki

Horii

et al. 2016

CRCP

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Introduction: Gastric metastasis of breast invasive ductal carcinoma is rare. We present a case of a patient developing aggressive recurrence of early breast invasive ductal carcinoma with gastric metastasis in the third year of adjuvant hormonal therapy. A rarely observed increase in human epidermal growth factor receptor 2 (HER2) overexpression was also observed at the recurrent metastatic sites, and this situation strongly influenced therapeutic management. Case presentation: A 49-year-old Japanese female with prolonged back pain was examined by abdominal ultrasound to eliminate the possibility of abdominal malignancy; she was found to have multiple tumors in the liver. Contrast-enhanced computed tomographic (CT) imaging was performed for thorough examination, revealing multiple tumors in abdominal lymph nodes and in the lungs in addition to the liver. An integrated positron emission tomographic CT scan showed metabolically active foci distributed throughout the body, including the thoracic and lumbar vertebrae, para-aortic lymph nodes, liver, and stomach. At the age of 46, the patient had undergone a lumpectomy without axillary lymph node dissection for early breast invasive ductal carcinoma (pT1N0M0 Stage I), and the cancer was positive for both estrogen and progesterone receptors while not overexpressing HER2. Currently, however, biopsies from gastric and liver tumors showed adenocarcinoma with histological and immunohistochemical properties similar to those of the previous breast invasive ductal carcinoma, indicating metastatic breast cancer. Interestingly, HER2 was overexpressed in the metastatic foci, and the difference in expression status influenced the choice of treatment. Conclusions: Aggressive recurrence of early breast invasive ductal carcinoma with gastric metastasis is rare. Furthermore, HER2 expression status differed between primary and metastatic foci, and reassessment of expression status was helpful for informing decisions on optimal treatment strategy.

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Metastatic Breast Cancer to the Stomach Resembling Early Gastric Cancer

Cited by 13 publications

References 12 publications

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

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

Breast Cancer Metastasis in the Stomach: When the Gastrectomy Is Indicated ?

Aggressive recurrence of early breast invasive ductal carcinoma with gastric metastasis during adjuvant hormonal therapy

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