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Histopathology ; Bladder metastases from breast cancer: Managing the unexpected. A systematic review. Urol Int DOI: Metastases in carcinoma; analysis of autopsied cases. Cancer ; Lyon: IARC; Metastatic patterns of invasive lobular versus invasive ductal carcinoma of the breast. Surgery ; Metastatic breast carcinoma to the bladder. In the current study, gastric lesions were described as polypoid masses or volcano-like ulcers and mostly involved the lower third of the stomach, including the antrum and pylorus. However, gastric metastases that have spread throughout the mucosa and gastric wall may resemble primary gastric cancer, making clinical management problematic.
Primary gastric diffuse signet-ring cell carcinoma and lobular breast carcinoma exhibit similar morphological features and these two neoplasms may be indistinguishable without further investigation Furthermore, primary stomach cancer is also able to metastasize to the breast, which may complicate the diagnosis 27 , The use of a variety of methods, including immunochemistry, may be helpful to differentiate gastric metastasis with morphologically similar tumors and tumors of unknown origin. However, as an established mediator of the carcinogenic process, HER-2 is dysregulated in a number of types of solid tumor, including breast and stomach cancer 31 and therefore it may not be a suitable diagnostic marker for gastric metastasis from breast cancer.
Taken together, it may be important for clinicians to not solely rely on the tumor biomarkers for the accurate diagnosis and treatment of gastric metastasis, due to the lack of a specific immunohistochemistry marker for breast cancer 32 and that the tumor phenotype may be unstable throughout the disease progression Therefore, the diagnosis and appropriate treatment of gastric metastases of breast cancer may be improved using a diverse approach from the clinician along with the use of numerous diagnostic methods that aid pathological diagnosis.
To the best of our knowledge, a small number of studies have been reported to investigate the prognostic factors and standard treatment strategies for gastric metastases of breast cancer due to the low incidence rate. Certain previous studies advocated systemic therapy for the cases of breast cancer that have metastasized to the stomach, rather than using surgery as a primary treatment option 12 , Surgery may only be considered in cases of acute complications, including stomach bleeding, obstruction and perforation, to improve quality of life 10 , However, other studies also hypothesized that surgery may be the optimal first-line treatment for operable solitary breast cancer metastasis to the stomach 29 , As presented in Fig.
This was partly as the hormonal receptors are typically positive in patients with gastric metastases. Therefore, the present study hypothesizes that the biological features of the primary breast tumors may partly contribute to the sensitivity to hormonal therapy of gastric metastases. Concordant with previous studies 24 , 37 , the present study demonstrated that low HER-2 expression was identified in gastric lesions 6. Further studies are important to evaluate the role of targeted therapy for this rare disease phenotype. In conclusion, the present study indicated that systemic treatment strategies, including hormonal therapy, may be the optimal choice for gastric metastasis from breast cancer.
The described case demonstrated that hormonal therapy was able to control the disease and provided a lengthy duration of relapse-free survival. Several limitations should be considered when interpreting the results of the present study. Firstly, the present study is retrospective and had a long duration and thus, the patients were heterogenous. In addition, the treatment modalities and the primary breast carcinoma features were heterogenous among distinct medical centres. In addition, the specific information concerning the primary tumor and follow-up was unavailable.
The current study focuses on the contributing factors of survival and appropriate treatments for patients with breast cancer with gastric metastases.
Prospective studies with a longer follow-up time and higher patient numbers may allow an improved understanding of the biological, pathological and clinicopathological characteristics, the clinical outcomes and the endoscopic features associated with gastric metastases from breast cancer. Dec 27— Epub ahead of print. View Article : Google Scholar.
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Treatment Continues to Improve for People with Metastatic Breast Cancer | Celgene Newsroom
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Secondary breast cancer after Hodgkin lymphoma: a case report and literature review
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Tot T: The role of cytokeratins 20 and 7 and estrogen receptor analysis in separation of metastatic lobular carcinoma of the breast and metastatic signet ring cell carcinoma of the gastrointestinal tract. Future Oncol. A diagnostic adjunct in the determination of primary site. Am J Clin Pathol. Eur J Surg Oncol. A systematic review and meta-analysis.
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Oncology Letters. Cited By CrossRef : 0 citations. This article is mentioned in:. 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.