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Koufopoulos NI, Boutas I, Pouliakis A, Samaras MG, Kotanidis C, Kontogeorgi A, Dimas DT, Ieronimaki AI, Leventakou D, Spathis A, Zanelli M, Palicelli A, Zizzo M, Goutas D, Pateras IS, Panayiotides IG. The "Forgotten" Subtypes of Breast Carcinoma: A Systematic Review of Selected Histological Variants Not Included or Not Recognized as Distinct Entities in the Current World Health Organization Classification of Breast Tumors. Int J Mol Sci 2024; 25:8382. [PMID: 39125951 PMCID: PMC11313581 DOI: 10.3390/ijms25158382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/26/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
Breast carcinoma is the most common cancer in women. Nineteen different subtypes of breast carcinomas are recognized in the current WHO classification of breast tumors. Except for these subtypes, there are a number of carcinomas with special morphologic and immunohistochemical features that are not included in the 5th WHO classification, while others are considered special morphologic patterns of invasive breast carcinoma of no special type. In this manuscript, we systematically review the literature on four different subtypes of invasive breast carcinoma, namely lymphoepithelioma-like breast carcinoma, breast carcinoma with osteoclast-like giant cells, signet-ring breast carcinoma, and metaplastic breast carcinoma with melanocytic differentiation. We describe their clinicopathological characteristics, focusing on the differential diagnosis, treatment, and prognosis.
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Affiliation(s)
- Nektarios I. Koufopoulos
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Ioannis Boutas
- Breast Unit, Rea Maternity Hospital, Palaio Faliro, 17564 Athens, Greece
| | - Abraham Pouliakis
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Menelaos G. Samaras
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Christakis Kotanidis
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Adamantia Kontogeorgi
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Dionysios T. Dimas
- Breast Unit, Athens Medical Center, Psychiko Clinic, 11525 Athens, Greece
| | - Argyro-Ioanna Ieronimaki
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Danai Leventakou
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Aris Spathis
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Magda Zanelli
- Pathology Unit, Azienda Unita Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Andrea Palicelli
- Pathology Unit, Azienda Unita Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Dimitrios Goutas
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Ioannis S. Pateras
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Ioannis G. Panayiotides
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
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Ibrahimli A, Aliyev A, Majidli A, Kahraman A, Galandarova A, Khalilzade E, Mammadli H, Huseynli K, Assaf K, Kilinc C, Muradov N, Alisan OF, Abdullayev S, Sahin YI, Samadov E. Metastasis to the stomach: a systematic review. F1000Res 2023; 12:1374. [PMID: 38706640 PMCID: PMC11066534 DOI: 10.12688/f1000research.140758.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 05/07/2024] Open
Abstract
Background: This study reviews the literature on gastric metastases (GM) in terms of diagnosis, treatment, and outcomes. The goal of this study was to provide clinicians with a reliable and beneficial source to understand gastric metastases arising from various primary tumors and to present the growing literature in an easily accessible form. Methods: Articles published in English language from implementation of MEDLINE and Cochrane databases until May 2022 were considered for the systematic review. Articles other than English language, letters to the editor, posters, and clinical images were excluded. Hematogenous and lymphogenic metastases were included whereas direct tumoral invasion and seeding were excluded. Articles and abstracts were analyzed and last selection was done after cross-referencing and by use of defined eligibility criteria. Results: In total 1,521 publications were identified and 170 articles were finally included totaling 186 patients with GM. The median age of patients was 62 years. Gynecologic cancer was the most common cancer type causing GM (67 patients), followed by lung cancer (33 patients), renal cancer (20 patients), and melanoma (19 patients). One of the main treatment methods performed for metastasis was resection surgery (n=62), sometimes combined with chemotherapy (ChT) or immunotherapy. ChT was the other most used treatment method (n=78). Also, immunotherapy was amongst the most preferred treatment options after surgery and ChT (n=10). Conclusions: As 172 case reports were screened in the systematic review from different journals, heterogeneity was inevitable. Some articles missed important information such as complete follow-up or clinical information. Moreover, since all of the included articles were case reports quality assessment could not be performed. Among 172 case reports reviewed, resection surgery was performed the most and was sometimes combined with ChT and immunotherapy. Further research about what type of treatment has the best outcomes for patients with gastric metastases is needed.
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Da Cunha T, Restrepo D, Abi-Saleh S, Dharan M. Breast cancer metastasizing to the upper gastrointestinal tract (the esophagus and the stomach): A comprehensive review of the literature. World J Gastrointest Oncol 2023; 15:1332-1341. [PMID: 37663940 PMCID: PMC10473935 DOI: 10.4251/wjgo.v15.i8.1332] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/01/2023] [Accepted: 07/05/2023] [Indexed: 08/10/2023] Open
Abstract
Breast cancer can infrequently metastasize to the upper gastrointestinal (GI) tract but the exact incidence is not well established-there is considerable variation between incidence reported from clinical studies and incidence noted in autopsy series. Clinical presentation can be very non-specific and often mimics primary gastrointestinal conditions. Endoscopy alone may not be sufficient to make a diagnosis and misdiagnosis is also common. A high degree of awareness and clinical suspicion is required to establish metastases to the upper GI tract. We undertook a comprehensive review of the available literature on breast cancer metastases to the esophagus and stomach including the clinical symptoms and presentation, endoscopic features, additional diagnostic imaging modalities, treatment and outcomes.
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Affiliation(s)
- Teresa Da Cunha
- Department of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT 06030, United States
| | - David Restrepo
- Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT 06030, United States
| | - Simon Abi-Saleh
- Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT 06030, United States
| | - Murali Dharan
- Department of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT 06030, United States
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Hanafiah M, Sidek S, Low SF, Ngiu CS. A CASE OF INFILTRATING LOBULAR CARCINOMA OF THE BREAST WITH GASTRIC METASTASIS 22 YEARS AFTER INITIAL SURGERY. Acta Clin Croat 2021; 60:136-140. [PMID: 34588734 PMCID: PMC8305346 DOI: 10.20471/acc.2021.60.01.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 05/31/2017] [Indexed: 11/24/2022] Open
Abstract
Gastric metastasis from breast carcinoma is uncommon and rarely encountered in our daily practice. We report a case of late gastric metastasis from previous infiltrating lobular carcinoma of the breast. The patient had extended disease-free interval of 22 years prior to metastasis. Gastroscopy and fluoroscopy showed changes appearing like linitis plastica of the body of the stomach. Computed tomography of the thorax and abdomen demonstrated pulmonary metastasis and mediastinal lymphadenopathy. Biopsy of the mediastinal lymph node and stomach lesion confirmed metastatic adenocarcinoma from breast carcinoma based on immunohistochemistry staining. Immunohistochemistry staining of both specimens revealed strong positivity for cytokeratin 7 and negative for cytokeratin 20.
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Affiliation(s)
| | - Sabrilhakim Sidek
- 1Radiology Department, Sunway Medical Centre, Bandar Sunway, Selangor, Malaysia; 2Department of Radiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia; 3Radiology Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 4Gastroenterology Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Soo Fin Low
- 1Radiology Department, Sunway Medical Centre, Bandar Sunway, Selangor, Malaysia; 2Department of Radiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia; 3Radiology Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 4Gastroenterology Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chai Soon Ngiu
- 1Radiology Department, Sunway Medical Centre, Bandar Sunway, Selangor, Malaysia; 2Department of Radiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia; 3Radiology Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 4Gastroenterology Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Rodrigues MVR, Tercioti-Junior V, Lopes LR, Coelho-Neto JDS, Andreollo NA. BREAST CANCER METASTASIS IN THE STOMACH: WHEN THE GASTRECTOMY IS INDICATED ? ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2017; 29:86-9. [PMID: 27438032 PMCID: PMC4944741 DOI: 10.1590/0102-6720201600020005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/26/2016] [Indexed: 12/16/2022]
Abstract
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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Affiliation(s)
- Marcus Vinicius Rozo Rodrigues
- Discipline of Diseases of the Digestive System and Gastrocentro Unit, Department of Surgery, Faculty of Medical Sciences, State University of Campinas - Unicamp, Campinas, SP, Brazil
| | - Valdir Tercioti-Junior
- Discipline of Diseases of the Digestive System and Gastrocentro Unit, Department of Surgery, Faculty of Medical Sciences, State University of Campinas - Unicamp, Campinas, SP, Brazil
| | - Luiz Roberto Lopes
- Discipline of Diseases of the Digestive System and Gastrocentro Unit, Department of Surgery, Faculty of Medical Sciences, State University of Campinas - Unicamp, Campinas, SP, Brazil
| | - João de Souza Coelho-Neto
- Discipline of Diseases of the Digestive System and Gastrocentro Unit, Department of Surgery, Faculty of Medical Sciences, State University of Campinas - Unicamp, Campinas, SP, Brazil
| | - Nelson Adami Andreollo
- Discipline of Diseases of the Digestive System and Gastrocentro Unit, Department of Surgery, Faculty of Medical Sciences, State University of Campinas - Unicamp, Campinas, SP, Brazil
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Kayılıoğlu SI, Akyol C, Esen E, Cansız-Ersöz C, Kocaay AF, Genç V, Kepenekçi İ, Demirer S. Gastric metastasis of ectopic breast cancer mimicking axillary metastasis of primary gastric cancer. Case Rep Gastrointest Med 2014; 2014:232165. [PMID: 25574403 PMCID: PMC4276682 DOI: 10.1155/2014/232165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 11/29/2014] [Indexed: 12/21/2022] Open
Abstract
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.
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Affiliation(s)
- Selami Ilgaz Kayılıoğlu
- Department of General Surgery, Ankara Numune Research and Training Hospital, 06100 Ankara, Turkey
| | - Cihangir Akyol
- Department of General Surgery, Ankara University School of Medicine, 06100 Ankara, Turkey
| | - Ebru Esen
- Department of Surgical Oncology, Ankara University School of Medicine, 06590 Ankara, Turkey
| | - Cevriye Cansız-Ersöz
- Department of Medical Pathology, Ankara University School of Medicine, 06100 Ankara, Turkey
| | - Akın Fırat Kocaay
- Department of General Surgery, Ankara University School of Medicine, 06100 Ankara, Turkey
| | - Volkan Genç
- Department of General Surgery, Ankara University School of Medicine, 06100 Ankara, Turkey
| | - İlknur Kepenekçi
- Department of General Surgery, Ankara University School of Medicine, 06100 Ankara, Turkey
| | - Seher Demirer
- Department of General Surgery, Ankara University School of Medicine, 06100 Ankara, Turkey
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Black AC, Lu D, Murakami S. Metastatic breast cancer masquerading as primary gastric cancer: case report and review of the literature. GASTROINTESTINAL CANCER RESEARCH : GCR 2014; 7:117-118. [PMID: 25276267 PMCID: PMC4171973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Alexander C. Black
- Division of Hematology-Oncology Department of Medicine David Geffen School of Medicine at UCLA Los Angeles, CA
| | - Danielle Lu
- Department of Pathology Huntington Medical Center Pasadena, CA
| | - Susan Murakami
- Department of Pathology Huntington Medical Center Pasadena, CA
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