1 Mar 2010Case Report
Gastric metastasis from breast carcinoma. Report of three cases, diagnostic-therapeutic critical close examination and literature review.
Andrea Ghirarduzzi 1Roberto Sivelli 1Eugenia Martella 2Mariangela Bella 3Belinda Simone 1Maria Arcuri 1Marco Zannoni 1Paolo Rio 1Mario Sianesi 1
Affiliations
Article Info
1 Institute of General Surgery and Organ Transplant - Azienda Ospedaliera Universitaria di Parma (University Hospital of Parma), Italy
2 Institute of Anatomy and Histology, University Hospital of Parma, Italy
3 Department of Medical Oncology, University Hospital of Parma, Italy
Ann. Ital. Chir., 2010, 81(2), 141-146;
Published: 1 Mar 2010
Copyright © 2010 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Gastric metastases of breast cancer represent a not so rare event in patients affected. In fact, it occurs in 0.3% of cases. Although the introduction of new adjuvant therapies has given rise to an increase in disease free survival and overall survival rates, it has also led to more frequent occurrences of breast cancer metastatic lesions localized in bone, lung/ pleura and liver, but above all in the stomach. The authors present three cases of patients suffering from breast cancer with secondary gastric neoplastic lesions from lobular and infiltrating ductal breast cancer. Lobular breast cancer is the histological type mostly involved in disseminated disease, with an incidence of 85% of cases. A review of the literature reveals that authors address the clinical and diagnostic problems of differentiating between a breast cancer metastasis to the stomach and a primary gastric cancer using recent diagnostic strategies to make an early diagnosis. Today practitioners have specific tests to detect early gastric cancer metastases of breast cancer such as endoscopic ultrasound, which provides a better endoscopic definition of the lesions, and immunohistochemical markers, able to distinguish the primary lobular histological type from ductal cancer. Besides, an early diagnosis associated with the latest adjuvant systemic therapies and hormonal treatment, alone or in combination, may grant affected patients a remission with a survival rate of 10-28 months, and a reasonable quality of life. At present the surgical approach should be reserved for selected cases and/or complications.
Keywords
- Breast
- Gastric cancer
- Metastasis