scholarly journals Duodenal and Biliary Obstruction due to Extrinsic CompressionDuodenal and Biliary Obstruction due to Extrinsic Compression by Recurrent Lobular Breast Carcinoma: A Case Report

2021 ◽  
pp. 870-877
Author(s):  
Rukaiya Bashir Hamidu ◽  
Bilal Asif ◽  
Harish Lavu ◽  
Thomas Kowalski ◽  
Daniel P. Silver
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Health Care Professionals ◽  
Primary Care Physicians ◽  
Biliary Obstruction ◽  
Previous History ◽  
Lobular Breast Cancer ◽  
Presenting Symptoms ◽  
Extrinsic Compression ◽  
Gi Symptoms

Metastases to the gastrointestinal tract (GIT) from breast carcinoma are rare, detected in approximately <5% of all breast cancer patients. Invasive lobular carcinoma (ILC) is the most common histological type of breast cancer to metastasize to the GIT. We report a case of abdominal recurrence of ILC of the breast causing intra-abdominal contracture leading to extrinsic compression of the duodenum and periampullary biliary tree. Four years after the patient’s diagnosis of a left breast pT1c, pN2, cM0 invasive lobular breast cancer, she presented with liver function tests consistent with biliary obstruction, and there was concern for a periampullary malignancy. Definitive diagnosis was achieved at laparotomy. This case demonstrates the importance of considering metastatic breast cancer as a potential cause of GI symptoms and radiological abnormalities affecting any part of the GIT of women with a previous history of lobular breast cancer. This case also highlights the effectiveness of chemotherapy in improving the survival and quality of life of these patients. Early recognition of this scenario enables prompt initiation of systemic therapy and avoids unnecessary surgical treatment. Despite the rarity, such patients will be encountered in clinical practice given the high prevalence of breast cancer. Moreover, the fact that the presenting symptoms of GI metastasis from breast cancer are usually not specific to the origin and mimic a primary intestinal disorder, health-care professionals beyond oncologists, especially gastroenterologists and primary care physicians, should be aware of this entity.

scholarly journals Excision of metastatic breast cancer from sternum and reconstruction in two patients with solitary metastatic spread

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Saifullah Mohamed ◽  
Khurum Mazhar ◽  
Ahmed Osman ◽  
Akshay Patel ◽  
Lakshmi Srinivasan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Previous History ◽  
Metastatic Breast ◽  
Extent Of Resection ◽  
Left Breast ◽  
Term Survival ◽  
Metastatic Breast Carcinoma ◽  
History Of ◽  
Treated Breast

Abstract Metastatic breast carcinoma is a relatively common clinical entity. However, the prognosis of oligometastatic and polygometastatic disease differs considerably pertaining to five-year survival. Metastatic breast carcinoma to the sternum has been described as early as 1988. We describe two cases in our institution who presented with solitary sternal metastases with a previous history of treated breast cancer. In both cases, there had been a history of previous left breast cancer treated aggressively with surgical resection and adjuvant oncological therapy and maintenance hormonal therapy. Partial sternectomy or total sternectomy for solitary metastatic sternal deposits is well established with relatively low morbidity and mortality and improvement in quality of life and possible improvement in long-term survival. Furthermore, reconstructive options are inherently dependent on extent of resection performed. These techniques can incorporate the use of sternal plates in order to approximate defects and reinforce the sternum in the setting of partial sternectomy.

scholarly journals Diarrhoea Caused by Diffuse Metastatic Lobular Breast Cancer

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Sjoerd F. Bakker ◽  
Willem Moolenaar ◽  
Marije M. van Santen ◽  
Mathijs P. Hendriks
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Gastrointestinal Symptoms ◽  
Laboratory Research ◽  
Ascending Colon ◽  
Lobular Breast Cancer ◽  
The Past ◽  
History Of ◽  
Lobular Breast Carcinoma ◽  
Descending Colon

A 70-year-old woman with a history of lobular breast cancer presented to our Outpatient Clinic with diarrhoea for the past 3 years. Clinical examination and laboratory research were normal. Colonoscopy showed diffuse mild erythema and a decreased vascular pattern. Biopsies from the ascending colon, transverse colon, and descending colon showed metastases of lobular breast carcinoma. Although gastrointestinal metastases are rare in breast cancer, our case emphasizes the need for further diagnostic efforts in patients with gastrointestinal symptoms and a history of breast carcinoma.

scholarly journals Lobular Breast Cancer in a Male Patient with a Previous History of Irradiation Due to Hodgkin’s Disease

Breast Care ◽  
2012 ◽  
Vol 7 (4) ◽  
pp. 315-318 ◽  
Author(s):  
Srdjan Ninkovic ◽  
Goran Azanjac ◽  
Milan Knezevic ◽  
Dragce Radovanovic ◽  
Dragan Canovic ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Male Patient ◽  
Previous History ◽  
Lobular Breast Cancer ◽  
History Of

Metastases from lobular breast cancer as an unusual source of GI bleeding.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12557-e12557
Author(s):  
Emily Clarke ◽  
James George ◽  
Andrew Peter Dean
Keyword(s):  
Breast Cancer ◽  
Abdominal Pain ◽  
Breast Carcinoma ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Gi Bleeding ◽  
Lobular Breast Cancer ◽  
Gi Tract ◽  
Invasive Ductal Breast Carcinoma ◽  
Lobular Breast Carcinoma

e12557 Background: With the exception of malignant melanoma, metastases to the GI tract are rare, especially as a first presentation of malignancy. We report a series of patients with GI metastases from lobular breast carcinoma as an unusual source of symptomatic GI bleeding. Methods: We conducted an electronic database search to identify solid tumour patients (excluding melanoma) with metastases to the GI tract. We then analysed the database by tumour type. Results: 3 cases of proven metastasis to the GI tract were identified. All had lobular breast cancer metastases. The database contained 240 patients with breast cancer, identifying 63 with infiltrating lobular carcinoma, 2 with micropapillary and 175 with invasive ductal carcinoma The 1st case had had invasive ductal breast carcinoma 6 years previously and presented with fatigue and shortness of breath from anaemia. Colonoscopy revealed a polyp which was removed. Histopathology showed metastatic lobular breast carcinoma. Further investigation then confirmed an occult breast mass with identical pathology. The 2nd case presented with 18 months of abdominal pain, previous colonoscopy was normal. After onset of anaemia and 25kg weight loss, upper GI endoscopy showed a markedly thickened stomach with evidence of recent bleeding and biopsies confirmed metastatic lobular breast carcinoma. The 3rd case presented with abdominal pain, subsequent blood tests showing a raised CA125 with omental and ovarian masses. Surgical debulking showed metastatic lobular breast carcinoma, though no primary breast lesion was detectable with mammography, ultrasound and MRI. 3 years later, investigation of anaemia with colonoscopy showed a caecal polyp with histology confirming lobular breast carcinoma. Conclusions: Despite all common tumour types being represented in the database it is notable that all 3 cases with mucosal GI metastases had lobular breast cancer. Previous evidence suggests a long latent period from initial diagnosis of breast cancer to development of GI metastases however our report suggests it can occur earlier in the illness. Clinicians should consider this as a rare cause of GI bleeding and further research to understand the mechanism of mucosal metastasis in lobular breast cancer is needed.

scholarly journals A84 LINITIS PLASTICA FROM A NON-GASTROINTESTINAL PRIMARY TUMOR: A CASE REPORT

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 98-99
Author(s):  
J Ghaith ◽  
I Alhafid ◽  
F Habal
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Breast Carcinoma ◽  
Complete Blood Count ◽  
Gastric Wall ◽  
Linitis Plastica ◽  
Clinical Syndrome ◽  
Screening Tests ◽  
Lobular Breast Cancer ◽  
Diagnostic Features

Abstract Background Infiltrative malignancies to the stomach are unusual and are difficult to detect. Linitis Plastic is a syndrome caused by submucosal invasion of the gastric wall. It represents Bormann type III or IV of gastric adenocarcinoma. Uncommonly, the latter can be a manifestation of lobular breast cancer. Aims To present a case report of lobular breast cancer that manifested primarily as Linitis Plastica (LP). We review the literature of LP as a clinical syndrome and the diagnostic challenges associated with this condition. We aim to increase the awareness of LP as a non-gastric tumor and its endoscopic features. Methods - Results A seventy-two-year-old female patient, previously healthy, presented with general deconditioning and distended abdomen. Basic laboratory testing such as complete blood count, electrolytes and kidney function were normal. Computed tomography of the abdomen and pelvis revealed moderately sized peritoneal carcinomatosis deposits on the abdominal wall. Her family history was non-contributary for any gastrointestinal or gynecological malignancies. On review of system, the patient noted a history of successful eradication of Helicobacter pylori infection remotely. Additionally, no preceding age-appropriate malignancy screening tests were reported. A gastroscopy was done looking for a primary gastrointestinal tumor exhibited abnormally stiff gastric wall, erythematous thickened mucosal folds, and non-distensible stomach. No clear lesions, submucosal masses or ulcers were visualized. The duodenal mucosa was noted to be normal. Twelve deep random biopsies were retrieved from the mucosal body and fundus. Following immunohistochemistry, the histological diagnosis revealed lobular adenocarcinoma of the breast. Conclusions Linitis Plastica (leather bottle stomach) or Brinton disease is a rare entity of diffuse gastric mucosa infiltrating tumor. LP depicts 3–10% of primary gastric carcinoma, whilst less than 10% are secondary breast cancer. Endoscopically, breast cancer-related LP can be divided into two morphologies: nodular pattern with ulceration, which is the typical presentation of ductal breast carcinoma and diffuse mural pattern in lobular breast carcinoma. LP is a unique condition with challenging diagnostic features. Many biopsies can result in negative histopathological diagnoses. This can be explained partially by 1. The scirrhous and fibrous stroma that forms LP tumors. 2. The deep location in the submucosa and muscular layer of the gastric wall. 3. Inability to identify this entity endoscopically. In one case report, Endoscopic Ultrasound-Fine Needle Aspirate (EUS-FNA) was incorporated after negative obtained biopsies. There are no standardized diagnostic approaches for LP. Further studies inquiring rates of missed malignant diagnoses and optimum diagnostic assessments in the setting of LP are needed. Funding Agencies None

scholarly journals Cowden Disease with Lhermitte-Duclos Disease: Case Report

2004 ◽  
Vol 31 (4) ◽  
pp. 542-549 ◽  
Author(s):  
Sujit S. Prabhu ◽  
Kenneth D. Aldape ◽  
Janet M. Bruner ◽  
Jeffrey S. Weinberg ◽  
Jeffrey S. Weinberg
Keyword(s):  
Breast Cancer ◽  
Previous History ◽  
Skin Lesions ◽  
Posterior Fossa Decompression ◽  
Cowden Disease ◽  
Lower Cranial Nerve ◽  
Presenting Symptoms ◽  
Disease Case ◽  
The Right ◽  
Cancer Multiple

Background:We report a case and review the recent literature describing 36 patients with both Lhermitte-Duclos disease (LDD) and Cowden disease (CD). Lhermitte-Duclos disease, or dysplastic gangliocytoma, is a benign hamartomatous condition involving the cerebellum. The presenting symptoms are usually headaches, gait ataxia, and symptoms of lower cranial nerve involvement. Cowden disease is a rare autosomal dominant disease that usually presents with multiple mucocutaneous lesions. Patients with CD are prone to multiple systemic malignancies, the most common of which is breast cancer. Recent studies have demonstrated an association between LDD and CD.Methods:A 44-year-old woman with a previous history of breast cancer, multiple benign skin lesions, Hashimoto's thyroiditis, and chronic headaches presented with exacerbation of her headaches during the previous year. Magnetic resonance imaging of the brain revealed a right cerebellar nonenhancing mass and an acquired tonsillar herniation.Results:The patient underwent resection of the right cerebellar mass, posterior fossa decompression, C1 and C2 laminectomies, and a duraplasty. Pathologic examination confirmed LDD. The patient recovered well after surgery, with immediate improvement of her headaches.Conclusion:The association between LDD and CD has been under-recognized and under-reported. Recognition of this association has direct clinical relevance, because diligent monitoring of individuals with LDD and CD may lead to the early detection of systemic malignancies.

scholarly journals Promoting Early Diagnosis of Breast Cancer in Nigeria Using Materials Designed to Cross Communication Barriers of Fear, Taboo and Literacy Between Health Care Teams and the Community at Risk From Breast Cancer

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 36s-36s
Author(s):  
C. Ellsworth Beaumont ◽  
E. Nwankwo
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Health Care Professionals ◽  
Primary Care Physicians ◽  
Community Education ◽  
Low Literacy ◽  
Cancer Society ◽  
Number Of Patients ◽  
The World ◽  
Before And After

Background: Nigeria, annually, has the highest numbers of death from breast cancer (BC) in Africa, estimated at 10,000. While BC incidence is declining in many parts of the world, it is increasing in Nigeria. Delay in BC diagnosis in Nigeria is due to: i) health care professionals (HCPs) and patients having poor knowledge of BC causation and symptoms; ii) incorrect diagnosis of symptoms; iii) delay in treatment seeking; iv) use of ineffective/harmful treatment methods.1 Low literacy rates, fear of cancer and the cultural taboos associated with BC create communication hurdles difficult to overcome.2 Aim: Increased HCP and patient of knowledge of BC causes, symptoms and detection, and improved communication between HCP and patients, resulting in increased and improved diagnostic protocol adherence, more patients self-reporting symptoms, and ultimately down-staging of patients. Methods: i) Aggregation of historical data of participating clinics of patients BC stage at diagnosis; ii) survey of HCP knowledge of BC symptoms and diagnostic protocols before and after seeing Worldwide Breast Cancer´s (WBC) Know Your Lemons (KYL) education materials; iii) frequency of display of KYL posters in clinics; iv) HCP survey of frequency of BC health discussions during a clinic visit; v) pre- and postsurvey of patient knowledge, interest and willingness to report symptoms at community education sessions, vi) count of number of patients reporting symptoms while making/attending clinic appointments. Results: Increase in HCP knowledge of symptoms and diagnostic protocols before and after seeing the KYL education materials; more visible use of patient friendly BC education materials displayed in the clinic; increase in frequency of breast health discussions initiated by HCPs with their patients; improved patient interest and knowledge of symptoms and diagnostic protocols; increase in patient confidence in being able to recognize a BC symptom; increase in patients making clinic appointments and self-referring symptoms to HCPs. Conclusion: As proven in other parts of the world with the KYL education materials, the researchers aim to prove, in undertaking this study in Lagos, Nigeria, that training HCPs (e.g., patient navigators, community workers, primary care physicians, mammography technicians) and patients in the signs/symptoms and risk factors for breast cancer using WBC´s bright, appealing and eye catching KYL materials can improve how HCPs and patients communicate about BC symptoms and detection option, which leads to earlier stage of diagnosis. 1. Agba et al, 2012; American Cancer Society, 2011; Cancer Today, 2012; Ogundipe, 2011; Osain, 2011; Prevalence of Breast Cancer, 2015. 2. Okpara and Kabongo, 2011; Total Facts Nigeria, 2017; World Atlas, 2017.

Navigating the health care system: perceptions of patients with chronic pain

2009 ◽  
Vol 29 (4) ◽  
pp. 162-168
Author(s):  
AL Dewar ◽  
K Gregg ◽  
MI White ◽  
J Lander
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Health Care System ◽  
Health Care Professionals ◽  
Primary Care Physicians ◽  
Treatment Compliance ◽  
Care Utilization ◽  
Semistructured Interviews ◽  
The Individual ◽  
Care System

A new framework is needed for patients with chronic pain and their primary care physicians that acknowledges the individual’s experiences and provides evidence-informed education and better linkages to community-based resources. This study describes the experience of 19 chronic-pain sufferers who seek relief via the health care system. Their experiences were recorded through in-depth semistructured interviews and analyzed through qualitative methods. The participants reported early optimism, then disillusionment, and finally acceptance of living with chronic pain. Both individuals with chronic pain and their health care professionals need evidence-informed resources and information on best practices to assist them to manage pain. Empathetic communication between health care professionals and individuals with chronic pain is crucial because insensitive communication negatively affects the individual, reduces treatment compliance and increases health care utilization.

Estrogen responsive finger protein as a new potential biomarker for breast cancer

2020 ◽  
Author(s):  
Lungwani Muungo
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Breast Carcinoma ◽  
Cancer Patients ◽  
Mrna Level ◽  
Significant Prognostic Factor ◽  
Breast Carcinomas ◽  
Finger Protein ◽  
Potential Biomarker ◽  
Human Breast Carcinomas

Purpose: Estrogen-responsive finger protein (Efp) is amember ofRINGfinger-B box-Coiled Coilfamily and is also a downstream target of estrogen receptor a. Previously, Efp was shown tomediate estrogen-induced cell growth, which suggests possible involvement in the developmentof human breast carcinomas. In this study, we examined expression of Efp in breast carcinomatissues and correlated these findings with various clinicopathologic variables.Experimental Design: Thirty frozen specimens of breast carcinomas were used for immunohistochemistryand laser capture microdissection/real-time PCR of Efp. Immunohistochemistryfor Efp was also done in 151breast carcinoma specimens fixed with formalin and embedded inparaffinwax.Results: Efp immunoreactivity was detected in breast carcinoma cells and was significantlyassociated with the mRNA level (n = 30). Efp immunoreactivity was positively associated withlymph node status or estrogen receptor a status and negatively correlated with histologic gradeor 14-3-3j immunoreactivity (n = 151). Moreover, Efp immunoreactivity was significantly correlatedwith poor prognosis of breast cancer patients, and multivariate analyses of disease-freesurvival and overall survival for151breast cancer patients showed that Efp immunoreactivity wasthe independentmarker.Conclusions: Our data suggest that Efp immunoreactivity is a significant prognostic factor inbreast cancer patients. These findings may account for an oncogenic role of Efp in the tumorprogression of breast carcinoma.

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