Covert Breast Cancer Metastasis to the Gastrointestinal Tract: Is Extra Vigilance Needed?

Breast cancer (BC) is a common cancer in females. Spread to the gastrointestinal tract is rare. This is a 61-year-old woman with history of T2N0M0 lobular BC treated 5 years earlier. She underwent endoscopic evaluation for new-onset anemia and was found to have multiple gastric ulcers, a normal-appearing duodenum, and subtle colonic nodules. Targeted and random biopsies of abnormal and normal findings, respectively, showed adenocarcinoma with diffuse immunohistochemical staining compatible with her BC history. This highlights the importance of maintaining a high suspicion index in patients with lobular BC and the utility of random biopsies in such cases.