• breast cancer
• endoscopy
• gastrointestinal tumors
• secondary
• tumor metastasis

• colonic metastasis
• duodenal metastasis
• gastric metastasis
• gastrointestinal metastases
• invasive lobular carcinoma
• metastatic breast cancer

• breast cancer
• cutaneous metastases
• endocrine therapy
• gastric metastases
• invasive lobular carcinoma

• Breast cancer
• biopsy
• case report
• endoscopy
• gastric metastasis
• immunohistochemistry

• Humans
• Female
• Breast Neoplasms/pathology
• Carcinoma, Lobular/pathology
• Stomach Neoplasms/diagnosis
• Stomach Neoplasms/pathology
• Lymphoma

• Anemia
• Breast cancer
• Case report
• Gastric metastasis
• Paraneoplastic syndrome

Breast cancer is the most common malignant tumor in adult women. Its common metastatic sites are lymph nodes, bones, lungs, the liver, and the brain. It is so rare for a patient with breast cancer to have metastases of the gastrointestinal tract, peritoneum, and ovary at the same time that the clinical reporting rate is low. We present a case of a 61-year-old woman who underwent right mastectomy and chemoradiotherapy 3 years ago because of mixed invasive ductal-lobular breast cancer. This time, she came to the hospital due to the symptom of stomach discomfort for 2 weeks. The gastroscopy biopsy result showed gastric metastasis from breast cancer. Then, ¹⁸F-FDG imaging and ⁶⁸Ga-FAPI PET/CT imaging were performed for further diagnosis; ⁶⁸Ga-FAPI PET/CT demonstrated a significantly elevated FAPI activity in the thickened gastric wall, peritoneum, and bilateral adnexal areas, which was superior to that of ¹⁸F-FDG. Finally, a biopsy of suspicious lesions was taken for pathological and histochemical examination, which confirmed that, in addition to the gastric metastasis, the peritoneum and bilateral ovaries were all consistent with metastatic breast cancer.

• Hebei Provincial Department of Bureau of Science and Technology

• breast cancer
• gastric cancer
• stomach and duodenum

Patient: Female, 58-year-old

Final Diagnosis: Gastric perforation

Symptoms: Abdominal pain • peritonitis

Medication: —

Clinical Procedure: Jejunostomy tube placement • laparoscopic surgery • open surgery

Specialty: Surgery

• breast neoplasms
• carcinoma
• gastrointestinal diseases

Distant metastases from breast cancer are frequently found in bones, lungs and the liver. Metastasis to the stomach is rare, and its clinical presentation remains unclear. The present report describes a case of isolated gastric metastasis from breast cancer identified by contrast-enhanced computed tomography (CT). A 45-year-old female patient underwent right mastectomy and axillary lymph node dissection after preoperative chemotherapy for right invasive lobular breast carcinoma T4bN2M0, stage IIIB. Postoperative radiotherapy and endocrine therapy with tamoxifen for 5 years were performed. CT for postoperative follow-up at 52 years old revealed thickening of the stomach wall. Although the patient was asymptomatic, erosive mucosa was observed on the gastric body during gastroscopy. The gastric lesion was immunohistochemically diagnosed as metastatic luminal disease from the breast cancer. Positron emission tomography/CT revealed no abnormal accumulation suggesting metastasis to other organs. Palbociclib and fulvestrant treatment were initiated for gastric metastasis. Invasive lobular breast carcinoma results in gastrointestinal metastasis, including the stomach, more frequently than invasive ductal breast carcinoma. However, most gastric metastases occur simultaneously with systemic metastases. Solitary metastasis to the stomach without symptoms as in this case has rarely been reported. The possibility of gastric metastasis should be considered among the differential diagnoses, even in the absence of symptoms, when gastrointestinal abnormalities are seen on CT in patients with a history of breast cancer.

• breast cancer
• computed tomography
• gastric metastasis

• GI bleeding
• breast cancer
• gastroenterology

• adrenal metastasis
• breast cancer
• diagnosis
• gastric metastasis
• gata3
• mammaglobin

• Adrenal Gland Neoplasms/diagnostic imaging
• Adrenal Gland Neoplasms/drug therapy
• Adrenal Gland Neoplasms/secondary
• Aged
• Breast Neoplasms/diagnostic imaging
• Breast Neoplasms/drug therapy
• Breast Neoplasms/pathology
• Female
• Humans
• Randomized Controlled Trials as Topic
• Stomach Neoplasms/diagnostic imaging
• Stomach Neoplasms/drug therapy
• Stomach Neoplasms/secondary

• acute abdomen
• breast cancer
• gastric metastasis
• total gastrectomy

Gastric outlet obstruction can be caused by various pathologies, including peptic ulcer disease, gastric polyps, and malignancies. The incidence rate of breast cancer metastasis to the stomach is only 0.3%. We describe a rare case of an 83-year-old female with a remote history of breast cancer who presented with symptoms of nausea and vomiting. She underwent an upper endoscopy, and biopsies revealed chronic gastritis. However, when she presented for the second time with similar symptoms, she underwent endoscopic ultrasound (EUS)-guided biopsies, which clinched the diagnosis of breast cancer metastasis causing gastric outlet obstruction. This case describes the importance of keeping a wide differential diagnosis for the causes of gastric outlet obstruction and the significance of deeper EUS-guided biopsies if initial endoscopic biopsies are inconclusive.

• breast adenocarcinoma
• endoscopic ultrasound
• gastric outlet obstruction
• upper gastrointestinal endoscopy

• Breast cancer
• gastric metastasis
• gastric perforation
• gross cystic disease fluid protein 15 (GCDFP-15)

The metastatic spread of breast carcinoma to the stomach is rare. There are a small number of previous studies that report metastases from the breast to the stomach and these provide limited information regarding this infrequent event. Consequently, the clinicopathological features, clinical outcomes and the optimal treatment for these patients remain to be elucidated. In the present study, 78 cases of gastric metastases from breast cancer, including the current case, were identified from previous studies between 1960 and 2015. The clinicopathological features of primary breast tumors and metastatic gastric lesions, including initial stage, tumor size, hormone receptor status, treatment modalities and overall survival (OS) rate, were analyzed. The patients were all female and the median age at the time of gastric metastasis diagnosis was 59 years old (range, 38–86 years). The majority of the patients initially presented with stage II breast cancer (35.9%) and abdominal pain was the most common symptom of gastric metastases (75.6%). A total of 51/78 patients (65.4%) were identified to have a history of invasive lobular breast carcinoma and the majority of gastric tumors were positive for hormonal receptors and human epidermal growth factor receptor 2 (HER-2) negative (estrogen receptor, 94.0%; progesterone receptor, 68.3%; HER-2, 5.9%). Furthermore, in the univariate analysis, multiple organs involved prior to or at the time of gastric metastases were diagnosed and multiple gastric lesions and peritoneal carcinomatosis were significantly correlated with OS. Additionally, salvage hormonal therapy, but not surgery or chemotherapy, significantly extended OS. However, in the multivariate analysis, metastasis prior to stomach involvement was the only independent indicator of poor OS. In conclusion, physicians must be vigilant when patients with breast cancer history present with gastrointestinal symptoms, despite gastric metastasis from breast cancer being rare. An appropriate systemic therapeutic strategy that includes hormonal therapy may be beneficial for this group of patients.

• breast cancer
• gastric metastasis
• hormone therapy
• invasive lobular carcinoma
• metastatic tumor

Breast cancer with stomach metastasis rare with an incidence of 1% or less among metastatic breast cancer patients. We experienced a case of breast cancer metastasizing to the stomach in 65-year-old female patient. She experienced dyspepsia and poor oral intake before visiting the clinic. Diffuse infiltration with nodular mucosal thickening of the stomach wall was observed, suggesting advanced gastric cancer based on gross endoscopic finding. Spread of poorly cohesive tumor cells in the gastric mucosa observed upon hematoxylin and eosin stain resembled signet ring cell carcinoma, but diffuse positive staining for GATA3 in immunohistochemical stain allowed for a conclusive diagnosis of breast cancer metastasizing to the stomach. Based on the final diagnosis, systemic chemotherapy was administered instead of primary surgical resection. After 2 cycles of docetaxel administration, she showed a partial response based on abdominal computed tomography scan. This case is an unusual presentation of breast cancer metastasizing to the gastrointestinal tract.

• Gastric cancer
• Breast cancer
• Metastasis
• Immunohistochemical stain
• GATA3
• GCDFP-15

• Aged
• Antineoplastic Agents/therapeutic use
• Biopsy
• Breast Neoplasms/diagnosis
• Breast Neoplasms/pathology
• Carcinoma, Signet Ring Cell/diagnosis
• Carrier Proteins/chemistry
• Diagnosis, Differential
• Drug Therapy
• Dyspepsia/diagnosis
• Endoscopy
• Female
• Gastrointestinal Tract/pathology
• Glycoproteins/chemistry
• Humans
• Immunohistochemistry
• Membrane Transport Proteins
• Neoplasm Metastasis
• Stomach Neoplasms/diagnosis
• Stomach Neoplasms/secondary
• Tomography, X-Ray Computed

A 52-year-old woman presented with stage IIB primary breast cancer (cT2N1M0), which was treated using neoadjuvant chemotherapy (epirubicin, cyclophosphamide, and paclitaxel). However, the tumor persisted in patchy areas; therefore, we performed modified radical mastectomy and axillary lymph node dissection. Routine endoscopy at 8 months revealed a depressed lesion on the gastric angle's greater curvature, and histology revealed signet ring cell proliferation. We performed endoscopic submucosal dissection for gastric cancer, although immunohistochemistry revealed that the tumor was positive for estrogen receptor, mammaglobin, and gross cystic disease fluid protein-15 (E-cadherin-negative). Therefore, we revised the diagnosis to gastric metastasis from the breast cancer.

Luminal gastrointestinal (GI) metastases from breast cancer are rare, reports are fragmentary and poor. The purposes of this study are to assess the gastrointestinal involvement from breast cancer in a retrospective study at a single institution and reviewing the related literature. Between January 2007 and December 2011 a total of 980 patients with breast cancer were treated at our institution, patients' records and report database were analysed. Institutional Review Board approval was obtained for this study. A search of the literature using PubMed, CancerLit, Embase, was performed. Selected for the present review were papers published in English before June 2012. Five of 980 patients (0.5%) showed gastrointestinal metastases from breast cancer, 3 patients had gastric involvement, 1 jejunum, and 1 rectum. Reviewing the literature, 206 patients affected by gastrointestinal metastasis from breast cancer were identified: the most frequent site of metastasis was the stomach (60%). The majority of the patients underwent chemotherapy and endocrine therapy, someone surgery and radiotherapy. GI metastases from breast cancer are rare, but possible, and a very late recurrence can also occur. Cyto-histological diagnosis is mandatory, to differentiate GI metastases from breast cancer to other diseases and to allow an adequate treatment.