Malinaric Rafaela, Balzarini Federica, Granelli Giorgia, Ferrari Arianna, Trani Giorgia, Ambrosini Francesca, Mantica Guglielmo, Panarello Daniele, De Rose Aldo Franco, Terrone Carlo
Department of Urology, L'Istituto di ricovero e cura a carattere scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy.
Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy.
Front Oncol. 2022 Sep 29;12:976947. doi: 10.3389/fonc.2022.976947. eCollection 2022.
Breast cancer is one of the most important causes of premature mortality in women worldwide. Around 12% of breast cancer patients will develop metastatic disease, a stage associated with poor prognosis, and only 26% of patients are likely to survive for at least 5 years after being diagnosed. Although the most common sites where breast cancer tends to spread are bones, lungs, brain, and liver, it is important that physicians consider other less frequent organs and viscera, like the bladder, as a target destination. In this article we report our experience with this rare form of metastases and a systematic literature review. We analyzed case reports, case series, and review articles present in PubMED/MEDLINE up to March 2022. We excluded the nonrelevant articles, editorials, letters to the editor, and articles written in other languages. We identified a total of 302 articles, with 200 articles being removed before screening; therefore, the total number of abstracts reviewed was 102. Fifty-five articles were excluded before full text review because they did not meet the inclusion criteria, and one article was not retrievable. Therefore, we included a total of 45 articles in this review. The intention of this review is to highlight the importance of the early detection of bladder metastases and to facilitate the diagnostic process for the responsible physician. The most common signs and symptoms and breast cancer subtype associated with bladder metastases, as well as overall survival after their detection, were all assessed. Bladder metastases from metastatic breast cancer are prevalent in the invasive, lobular breast cancer subtype; most patients present with hematuria (39.5%) and the relative 5-year survival rate is 2%. The main limitations of this review are the low number of cases reported in the literature, clinical and pathological differences between the individual cases, and absence of the control group. This study was not funded.
乳腺癌是全球女性过早死亡的最重要原因之一。约12%的乳腺癌患者会发展为转移性疾病，这一阶段预后较差，只有26%的患者在确诊后可能存活至少5年。尽管乳腺癌最常见的转移部位是骨骼、肺部、大脑和肝脏，但医生将其他不太常见的器官和内脏（如膀胱）视为潜在转移目标也很重要。在本文中，我们报告了我们对这种罕见转移形式的经验以及系统的文献综述。我们分析了截至2022年3月发表在PubMed/MEDLINE上的病例报告、病例系列和综述文章。我们排除了不相关的文章、社论、给编辑的信以及用其他语言撰写的文章。我们共识别出302篇文章，在筛选前剔除了200篇；因此，审查的摘要总数为102篇。在全文审查前，有55篇文章因不符合纳入标准而被排除，还有一篇文章无法获取。因此，我们在本综述中总共纳入了45篇文章。本综述的目的是强调早期发现膀胱转移的重要性，并为负责的医生简化诊断过程。我们评估了与膀胱转移相关的最常见体征和症状、乳腺癌亚型以及检测后的总生存率。转移性乳腺癌的膀胱转移在浸润性小叶乳腺癌亚型中较为普遍；大多数患者表现为血尿（39.5%），相对5年生存率为2%。本综述的主要局限性在于文献报道的病例数量较少、个体病例之间存在临床和病理差异以及缺乏对照组。本研究没有资金支持。
