Second Department of Internal Medicine, Attikon University Hospital, Rimini 1, Haidari, Athens, Greece.
Anticancer Res. 2009 Nov;29(11):4759-63.
Breast cancer metastasis to the stomach is rare. It is very important to distinguish a breast cancer metastasis to the stomach from a primary gastric cancer on the basis of clinical, endoscopic, radiological and histopathological features, in order to administer the appropriate treatment.
Eight patients with breast cancer metastasis to the stomach were identified in our database between 1995 and 2008. The clinicopathological data and outcome from the medical records of these patients were then reviewed.
The median age at initial breast cancer diagnosis was 59.5 years (range 44-75 years), while the median interval between the primary breast cancer and the gastric involvement was 41 months (range 2-82 months). The primary breast cancer histological subtype was mostly lobular carcinoma. All the biopsy specimens were estrogen receptor (ER), cytokeratin (CK) 7 and gross cystic disease fluid protein-15 (GCDFP-15) positive and CK-20 negative, while two of them (25%) were HER-2-neu positive. All the patients received chemotherapy and two of them were also treated with hormonal treatment. Two patients underwent surgical intervention, while one patient who had gastric involvement as the only metastatic site will proceed to surgical resection of the stomach. All these three patients were alive after 9, 39 and 44 months of follow-up, respectively. The response rate to chemotherapy was 50% (1 complete response [CR], 3 partial responses [PR]), and the median survival was 11 months (range, 1-44+ months).
Breast cancer metastasis to the stomach can be differentiated from primary gastric cancer by comparing the biopsies from the gastric metastasis with the original histological slides from the primary breast tumor. Appropriate systemic treatment for metastatic breast carcinoma is the preferred treatment, whereas surgical intervention should be reserved for palliation or may be indicated in cases of solitary resectable gastrointestinal tract metastases.
乳腺癌转移至胃部较为罕见。为了给予适当的治疗，根据临床、内镜、影像学和组织病理学特征，区分乳腺癌转移至胃部与原发性胃癌非常重要。
我们的数据库中在 1995 年至 2008 年间共发现 8 例乳腺癌转移至胃部的患者。随后对这些患者的病历进行了回顾性分析，包括临床病理数据和结局。
初次乳腺癌诊断时的中位年龄为 59.5 岁（范围 44-75 岁），而原发性乳腺癌与胃受累之间的中位间隔时间为 41 个月（范围 2-82 个月）。原发性乳腺癌的组织学亚型主要为小叶癌。所有活检标本均为雌激素受体（ER）、细胞角蛋白（CK）7 和 gross cystic disease fluid protein-15（GCDFP-15）阳性，CK-20 阴性，其中 2 例（25%）为 HER-2-neu 阳性。所有患者均接受了化疗，其中 2 例还接受了激素治疗。2 例患者接受了手术干预，而 1 例仅有胃部转移的患者将接受胃切除术。这 3 例患者分别在随访 9、39 和 44 个月后仍存活。化疗的客观缓解率为 50%（1 例完全缓解[CR]，3 例部分缓解[PR]），中位生存期为 11 个月（范围，1-44+个月）。
通过比较胃转移的活检标本与原发性乳腺癌的原始组织学切片，可以将乳腺癌转移至胃部与原发性胃癌区分开来。转移性乳腺癌的适当全身治疗是首选治疗方法，而手术干预应保留用于姑息治疗，或可能适用于孤立性可切除胃肠道转移的情况。
