Abstract
Breast cancer is the most common malignancy in females. Common sites of metastases include the liver, lung, bone, and brain, while metastases to the extrahepatic digestive system are very rare. This report presents a patient diagnosed with breast carcinoma metastasis in the terminal ileum. The patient underwent breast-conserving surgery on both breasts because of breast cancer at the age of 46 years. Both breast cancers were consistent with stage I invasive ductal carcinomas. Colonoscopy during an investigation for hematochezia revealed a 2-cm ulceration in the terminal ileum 22 months later, and microscopic examination of a biopsy specimen of the ulceration revealed a poorly differentiated mass that was strongly suggestive of metastatic adenocarcinoma with endolymphatic tumor emboli. She underwent hand-assisted laparoscopic ileocecectomy because of ileal metastasis. She had a family history of breast cancer (sister) and colon cancer (brother). She exhibited HER2/neu discordance and carried the BRCA2 gene mutation. Surgeons should remain aware that breast cancer can metastasize to the gastrointestinal tract.
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Asch MJ, Wiedel PD, Habif DV. Gastrointestinal metastases from crcinoma of the breast. Autopsy study and 18 cases requiring operative intervention. Arch Surg 1968;96:840–843.
Tohfe M, Shami P, Aftimos G, Saade M. Gastrointestinal metastases from breast cancer: a case report. South Med J 2003;96: 624–625.
Washington K, McDonagh D. Secondary tumors of the gastrointestinal tract: surgical pathologic findings and comparison with autopsy survey. Mod Pathol 1995;8:427–433.
Robson M, Gilewski T, Haas B, Levin D, Borgen P, Rajan P, et al. BRCA-associated breast cancer in young women. J Clin Oncol 1998;16:1642–1649.
Chen S, Iversen ES, Friebel T, Finkelstein D, Weber BL, Eisen A, et al. Characterization of BRCA1 and BRCA2 mutations in a large United States sample. J Clin Oncol 2006;24:863–871.
Antoniou A, Pharoah PD, Narod S, Risch HA, Eyfjord JE, Hopper JL, et al. Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case Series unselected for family history: a combined analysis of 22 studies. Am J Hum Genet 2003;72:1117–1130.
Harris MHA, Chrissohou M, Swindell M, Hudson M, Sellwood RA. A comparison of the metastatic pattern of infiltrating lobular carcinoma and infilterating ductal carcinoma. Br J Cancer 1984;50: 23–30.
Taal BG, Peterse H, Boot H. Clinical presentation, endoscopic features, and treatment of gastric metastases from breast carcinoma. Cancer 2000;89:2214–2221.
Hansen RM, Lewis JD, Janjan NA, Komorowski RA. Occult carcinoma of the breast masquerading as primary adenocarcinoma of the small intestine. A case report. J Clin Gastroenterol 1988;10:213–217.
McLemore EC, Pockaj BA, Reynolds C, Gray RJ, Hernandez JL, Grant CS, et al. Breast cancer: presentation and intervention in women with gastrointestinal metastasis and carcinomatosis. Ann Surg Oncol 2005;12:886–894.
Borst MJ, Ingold JA. Metastatic patterns of invasive lobular versus invasive ductal carcinoma of the breast. Surgery 1993;114:637–641; discussion 41–2.
Dent R, Warner E. Screening for hereditary breast cancer. Semin Oncol 2007;34:392–400.
Lower EE, Glass EL, Bradley DA, Blau R, Heffelfinger S. Impact of metastatic estrogen receptor and progesterone receptor status on survival. Breast Cancer Res Treat 2005;90:65–70.
Holdaway IM, Bowditch JV. Variation in receptor status between primary and metastatic breast cancer. Cancer 1983;52: 479–485.
Sekido Y, Umemura S, Takekoshi S, Suzuki Y, Tokuda Y, Tajima T, et al. Heterogeneous gene alterations in primary breast cancer contribute to discordance between primary and asynchronous metastatic/recurrent sites: HER2 gene amplification and p53 mutation. Int J Oncol 2003;22:1225–1232.
Cui X, Schiff R, Arpino G, Osborne CK, Lee AV. Biology of progesterone receptor loss in breast cancer and its implications for endocrine therapy. J Clin Oncol 2005;23:7721–7735.
Molina R, Auge JM, Escudero JM, Filella X, Zanon G, Pahisa J, et al. Evaluation of tumor markers (HER-2/neu oncoprotein, CEA, and CA 15.3) in patients with locoregional breast cancer: prognostic value. Tumour Biol 2010;31:171–180.
Lipton A, Leitzel K, Ali SM, Demers L, Harvey HA, Chaudri-Ross HA, et al. Serum HER-2/neu conversion to positive at the time of disease progression in patients with breast carcinoma on hormone therapy. Cancer 2005;104:257–263.
Tanner M, Jarvinen P, Isola J. Amplification of HER-2/neu and topoisomerase IIalpha in primary and metastatic breast cancer. Cancer Res 2001;61:5345–5348.
Zidan J, Dashkovsky I, Stayerman C, Basher W, Cozacov C, Hadary A. Comparison of HER-2 overexpression in primary breast cancer and metastatic sites and its effect on biological targeting therapy of metastatic disease. Br J Cancer 2005;93: 552–556.
Tapia C, Savic S, Wagner U, Schonegg R, Novotny H, Grilli B, et al. HER2 gene status in primary breast cancers and matched distant metastases. Breast Cancer Res 2007;9:R31.
Gancberg D, Di Leo A, Cardoso F, Rouas G, Pedrocchi M, Paesmans M, et al. Comparison of HER-2 status between primary breast cancer and corresponding distant metastatic sites. Ann Oncol 2002;13:1036–1043.
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Cho, D.H., Jeon, Y.S., Choi, MY. et al. Ileal metastasis of breast cancer in a patient with a BRCA2 gene mutation: Report of a case. Surg Today 41, 1665–1669 (2011). https://doi.org/10.1007/s00595-011-4503-5
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DOI: https://doi.org/10.1007/s00595-011-4503-5