Metastatic ductal carcinoma of the breast to colonic mucosa

Abstract

Breast cancer is the most common malignancy among women, while invasive ductal carcinoma is the most common type of invasive breast cancer. Metastatic spread to the colon and rectum in breast cancer is rare. This report describes a case of a 69-year-old woman with metastatic ductal breast cancer to the rectosigmoid, presenting as an incidental finding on screening colonoscopy. The breast carcinoma was first diagnosed 2 years prior. Colonic biopsies from colonoscopy confirmed metastatic adenocarcinoma consistent with a breast primary. Ultimately her clinical condition worsened as she developed malignant ascites, a small bowel obstruction, and new bone metastases, and the patient succumbed to her illness. Cases of metastatic breast cancer to the gastrointestinal tract have predominantly been lobular breast carcinoma. Increased awareness of colonic metastasis may lead to more accurate diagnosis and earlier systemic treatment.

Screening Colonoscopy Unmasking Colonic Metastasis from an Occult Breast Ductal Carcinoma: A Case Report and Review of the Literature

“…In terms of prognosis, it is unclear whether GI or colonic mets independently confer a poorer prognosis in breast cancer. The overall survival in the reported cases has ranged from few months (especially in the setting of bleeding/obstruction) up to 5 years [25]. In our literature review of other breast IDC with colonic mets, the median overall survival was 12 months (range 6-60 months); however, this has many limitations.…”

Rectal Metastases of Breast Carcinoma: A Case Report

“…Female breast cancer is very common, affecting 12.5% of women during their lifetime. 2,3,[6][7][8][9] The risk of distant metastases from breast cancers is around 50%. 4 Breast tumors greater than 2 cm in diameter and metastatic lymph nodes are factors for distant implants, 4 as observed in our patient with a neoplasm over 10 cm and osseous plus GI metastases.…”

“…Metastasis to the gastrointestinal (GI) tract is uncommon, mainly if breast is the primary site; clinical manifestations are usually non-specific with symptoms related to local factors and extension of the bowel involvement. [1][2][3][4][5][6][7][8][9] Breast cancer affects lymph nodes, bones, lungs, liver, brain, and soft tissues, but rectal spread is very rare. [2][3][4][5][6][7][8][9] Lobular carcinoma is a major subtype in GI implants with up to 18% of incidence.…”

“…[1][2][3][4][5][6][7][8][9] Breast cancer affects lymph nodes, bones, lungs, liver, brain, and soft tissues, but rectal spread is very rare. [2][3][4][5][6][7][8][9] Lobular carcinoma is a major subtype in GI implants with up to 18% of incidence. 1,2,[4][5][6][7][8][9] The period between the primary tumor diagnosis and evidence of implants is variable and reported to be up to 30 years.…”

“…[2][3][4][5][6][7][8][9] Lobular carcinoma is a major subtype in GI implants with up to 18% of incidence. 1,2,[4][5][6][7][8][9] The period between the primary tumor diagnosis and evidence of implants is variable and reported to be up to 30 years. 1,4,8,9 The diagnosis of breast cancer ocasionally occurs after manifestations of the rectal metastases.…”