Breast cancer metastasizing to the upper gastrointestinal tract (the esophagus and the stomach): A comprehensive review of the literature

Table 1 Clinical characteristics of patients with metastatic breast cancer to upper gastrointestinal tract

	Esophagus (%)	Stomach (%)
Age (years)	64	57.3
Breast cancer type
Lobular	4 (29)	135 (72)
Ductal	9 (64)	49 (36)
Initial treatment of breast cancer
Surgery	65 (97)	70 (80)
Radiotherapy	33 (49)	28 (32)
Chemotherapy	20 (30)	42 (48)
Hormonal Therapy	13 (19)	33 (38)
Median time between diagnosis of primary breast cancer and GI metastases (years)	10	4

GI: Gastrointestinal.

Table 2 Clinical symptoms of patients with metastatic breast cancer to upper gastrointestinal tract

	Esophagus (%)	Stomach (%)
Symptoms
Dysphagia	50 (96)	-
Weight loss/anorexia	16 (31)	80 (42)
Abdominal pain	-	108 (57)
Nausea/vomiting	-	82 (43)
Gastrointestinal bleed	-	22 (12)

Table 3 Endoscopic characteristics of patients with metastatic breast cancer to upper gastrointestinal tract

	Esophagus (%)	Stomach (%)
Location
Upper third of the esophagus	8 (13)	-
Middle third of the esophagus	40 (66)	-
Lower third of the esophagus	13 (21)	-
Proximal stomach	-	24 (21)
Middle stomach	-	13 (11)
Distal stomach	-	38 (32)
Diffuse in the stomach	-	42 (36)
Endoscopic findings
Normal mucosa	56 (84)	-
Mucosal changes	6 (9)	-
Stenosis	41 (61)	-
Mass	2 (3)	4(3)
Linitis plastica	-	44 (36)
Ulcer	-	30 (25)
Polyps	-	7 (6)
Nodularity	-	7 (6)
External compression	-	23 (19)

Table 4 Hormone status and immunohistochemistry markers for patients with metastatic breast cancer to upper gastrointestinal tract

	Esophagus (%)	Stomach (%)
Tumor receptors of primary breast tumor
ER+	4 (67)	37 (88)
ER-	3 (50)	5 (12)
PRG+	2 (33)	29 (69)
PRG-	4 (67)	12 (29)
HER+	0 (0)	2 (5)
HER-	3 (50)	23 (55)
Tumor receptors and markers of gastrointestinal metastases
ER+	13 (100)	86 (57)
ER-	-	39 (26)
PRG+	9 (69)	30 (20)
PRG-	-	18 (12)
HER+	1 (8)	8 (5)
HER-	1 (8)	38 (25)
CK7+	3 (23)	25 (17)
CK20+	-	1 (1)
CK20-	3 (23)	18 (12)

Table 5 Treatment and outcomes of patients with metastatic breast cancer to the upper gastrointestinal tract

	Esophagus (%)	Stomach (%)
Treatment of primary tumor
Surgery	65 (97)	70 (80)
Radiotherapy	33 (49)	28 (32)
Hormonal therapy	13 (19)	33 (38)
Chemotherapy	20 (30)	42 (48)
Treatment of metastases
Surgery	20 (30)	12 (11)
Surgery and chemotherapy/hormonal therapy	13 (20)	15 (15)
Chemotherapy/hormonal therapy	15 (23)	74 (70)
Radiotherapy only	6 (9)	3 (3)
Radiation and chemotherapy/hormonal therapy	10 (15)	-
Dilation	32 (48)	-
Stent placement	9 (14)	-
Outcome
Alive at one month	7 (13)	-
Alive at one year	19 (35)	13 (24)
Dead at 1 yr	24 (44)	20 (37)
Dead at 2 yr	-	18 (33)
Dead at 5 yr	9 (16)	-
Dead at 10 yr	-	1 (2)