Lyu Zhidong, Fei Jie, Zhang Longxiao, Liu Yinbo
Department of Breast Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Front Oncol. 2025 Aug 21;15:1576874. doi: 10.3389/fonc.2025.1576874. eCollection 2025.
Gastric metastasis of breast cancer is rare, and clinical data on its treatment and prognosis are limited at present. Herein, we report a case of gastric metastasis arising from invasive ductal and mucinous carcinoma of the breast and review the literature. A 51-year-old woman was diagnosed with infiltrating and mucinous carcinoma of the right breast accompanied by ipsilateral axillary lymph node and subclavian lymph node metastases. The molecular subtype was luminal A, and the clinical stage was T4bN3M0. The patient first received 5 cycles of neoadjuvant chemotherapy, and the treatment efficacy was stable. After 3 months of treatment with abemaciclib combined with exemestane, the tumors did not significantly reduce in size. The patient underwent surgery on February 23, 2023. The postoperative pathological examination revealed Miller Payne system grade 3 (G3). Cancer metastasis (14/20) was observed in the axillary lymph nodes, and the immunohistochemical results were as follows: ER (++, 90%), PR (+, 2%), HER-2 (3+), and Ki-67 (20%). The adjuvant therapy used was exemestane combined with trastuzumab and pertuzumab. Gastric metastasis was observed 10 months after surgery. The pathological examination revealed focal atypical cell nests with disordered arrangements, indicating malignant lesions (cancer). The immunohistochemical results were as follows: GATA3 (+), ER (++, 90%), PR (-), and HER-2 (1+). In the late stage, first-line treatment with dalpiciclib and fulvestrant was administered, and liver metastasis occurred 10 months thereafter. T-DXd treatment was subsequently administered, and the patient is currently undergoing clinical follow-up. This case highlights the possibility of gastric metastasis when gastrointestinal symptoms occur in patients with a history of breast cancer.
乳腺癌胃转移罕见，目前关于其治疗和预后的临床数据有限。在此，我们报告一例由乳腺浸润性导管癌和黏液癌引起的胃转移病例并复习文献。一名51岁女性被诊断为右乳腺浸润性黏液癌，伴有同侧腋窝淋巴结和锁骨下淋巴结转移。分子亚型为腔面A型，临床分期为T4bN3M0。患者首先接受了5个周期的新辅助化疗，治疗效果稳定。使用阿贝西利联合依西美坦治疗3个月后，肿瘤大小未显著缩小。患者于2023年2月23日接受手术。术后病理检查显示米勒-佩恩系统3级（G3）。在腋窝淋巴结中观察到癌转移（14/20），免疫组化结果如下：雌激素受体（ER，++，90%）、孕激素受体（PR，+，2%）、人表皮生长因子受体2（HER-2，3+）、增殖细胞核抗原（Ki-67，20%）。辅助治疗采用依西美坦联合曲妥珠单抗和帕妥珠单抗。术后10个月观察到胃转移。病理检查显示局灶性非典型细胞巢排列紊乱，提示为恶性病变（癌）。免疫组化结果如下：GATA3（+）、ER（++，90%）、PR（-）、HER-2（1+）。晚期给予达尔西利和氟维司群一线治疗，10个月后发生肝转移。随后给予T-DXd治疗，患者目前正在接受临床随访。该病例突出了有乳腺癌病史的患者出现胃肠道症状时发生胃转移的可能性。
