Gastric metastasis from breast carcinoma. Report of three cases, diagnostic-therapeutic critical close examination and literature review

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COD: 141-146-1 Categorie: ,

Andrea Ghirarduzzi, Roberto Sivelli, Eugenia Martella, Mariangela Bella, Belinda De Simone, Maria Francesca Arcuri, Marco Zannoni, Paolo Del Rio, Mario Sianesi

Ann. Ital. Chir., 2010; 81: 141-146

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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.

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