Metastatic gastric cancer from breast carcinoma: A report of 78 cases.
Metastatic gastric cancer from breast carcinoma: A report of 78 cases.
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DOI：
10.3892/ol.2017.6703
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发表时间：
2017-10
期刊：
影响因子：
2.9
通讯作者：
Zhang F
中科院分区：
文献类型：
--
作者：
Xu L;Liang S;Yan N;Zhang L;Gu H;Fei X;Xu Y;Zhang F
乳腺癌转移到胃的情况很少见。有少数先前的研究报道了从乳房转移到胃的情况，这些研究提供了关于这一罕见事件的有限信息。因此，这些患者的临床病理特征、临床转归和最佳治疗方法仍有待阐明。在本研究中，从1960至2015年间的先前研究中确定了78例乳腺癌胃转移病例，包括目前的病例。分析原发乳腺肿瘤和胃转移瘤的临床病理特征，包括肿瘤的初始分期、肿瘤大小、激素受体状态、治疗方法和总生存率。患者均为女性，确诊时的中位年龄为59岁(38-86岁)。大多数患者以II期乳腺癌为首发症状(35.9%)，腹痛是胃转移最常见的症状(75.6%)。78例患者中有51例(65.4%)有浸润性小叶乳腺癌病史，大多数胃肿瘤激素受体阳性，而人表皮生长因子受体2(HER-2)阴性(雌激素受体94.0%，孕激素受体68.3%，HER-2 5.9%)。单因素分析显示，胃转移前或转移时有多个器官受累，胃多发性病变和腹膜癌与OS显著相关。此外，挽救激素治疗，而不是手术或化疗，可显著延长OS。然而，在多变量分析中，胃受累之前的转移是唯一独立的OS不良指标。总之，当有乳腺癌病史的患者出现胃肠道症状时，医生必须保持警惕，尽管乳腺癌的胃转移很少见。适当的系统治疗策略，包括激素治疗，可能对这类患者有益。
The metastatic spread of breast carcinoma to the stomach is rare. There are a small number of previous studies that report metastases from the breast to the stomach and these provide limited information regarding this infrequent event. Consequently, the clinicopathological features, clinical outcomes and the optimal treatment for these patients remain to be elucidated. In the present study, 78 cases of gastric metastases from breast cancer, including the current case, were identified from previous studies between 1960 and 2015. The clinicopathological features of primary breast tumors and metastatic gastric lesions, including initial stage, tumor size, hormone receptor status, treatment modalities and overall survival (OS) rate, were analyzed. The patients were all female and the median age at the time of gastric metastasis diagnosis was 59 years old (range, 38–86 years). The majority of the patients initially presented with stage II breast cancer (35.9%) and abdominal pain was the most common symptom of gastric metastases (75.6%). A total of 51/78 patients (65.4%) were identified to have a history of invasive lobular breast carcinoma and the majority of gastric tumors were positive for hormonal receptors and human epidermal growth factor receptor 2 (HER-2) negative (estrogen receptor, 94.0%; progesterone receptor, 68.3%; HER-2, 5.9%). Furthermore, in the univariate analysis, multiple organs involved prior to or at the time of gastric metastases were diagnosed and multiple gastric lesions and peritoneal carcinomatosis were significantly correlated with OS. Additionally, salvage hormonal therapy, but not surgery or chemotherapy, significantly extended OS. However, in the multivariate analysis, metastasis prior to stomach involvement was the only independent indicator of poor OS. In conclusion, physicians must be vigilant when patients with breast cancer history present with gastrointestinal symptoms, despite gastric metastasis from breast cancer being rare. An appropriate systemic therapeutic strategy that includes hormonal therapy may be beneficial for this group of patients.
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影响因子：
0.9
作者：
Sobinsky, Justin D.;Willson, Thomas D.;Connolly, Mark M.
通讯作者：
Connolly, Mark M.
影响因子：
3.4
作者：
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影响因子：
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作者：
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通讯作者：
Hoff, P. M.
DOI：
10.1046/j.1524-4741.2000.98072.x
发表时间：
2000-01-01
期刊：
The breast journal
影响因子：
--
作者：
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通讯作者：
Weese, James L.
影响因子：
4
作者：
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通讯作者：
Sekiya, Masao