Infiltrating Ductal Breast Carcinoma Metastasized to the Rectum: A Case Report and a Review of the Literature

2021 ◽  
Author(s):  
Bo Ban ◽  
Yong-Ping Yang ◽  
Jian-Nan Li ◽  
Kai Zhang ◽  
Tong-Jun Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Present Report ◽  
Anal Verge ◽  
Radical Mastectomy ◽  
Axillary Lymph ◽  
Ductal Breast Carcinoma ◽  
Distal Rectum ◽  
Pathological Subtype ◽  
Rectal Metastasis

Abstract BACKGROUND:Gastrointestinal (GI) metastasis in breast cancer (BC) is uncommon, although in the rare cases when it occurs, infiltrating lobular carcinoma is the most commonly reported pathological subtype. Nonetheless, gastrointestinal metastasis from infiltrating ductal breast carcinoma is extremely rare and usually occurs several years after the appearance of the primary tumor. The present study was, to the best of our knowledge, the first one to present a case of distal rectum metastasis originating from infiltrating ductal breast carcinoma. CASE PRESENTATION:The present report discusses the case of a Chinese female patient aged 37 years. The patient presented with diarrhea along with bloody stools and anal bearing-down pain. Earlier in 2015, she had undergone axillary lymph node dissection (LND) and right modified radical mastectomy in another hospital to treat the infiltrating ductal breast carcinoma pT1N1M0. The presented symptoms were investigated by performing colonoscopy, which indicated lower rectal swelling at 3 cm on the top of the anal verge. Further investigation with positron emission tomography-computed tomography (PET-CT) revealed an uptake of fluorodeoxyglucose (FDG) within the distal rectum as well as in the left acetabulum. The samples from laparoscopic exploration were biopsied, which revealed metastases of breast cancer. Therefore, the patient was intraoperatively diagnosed with the rectal metastasis of BC and was treated with laparoscopic radical abdominoperineal resection. Furthermore, the immunohistochemical analysis of the tumor confirmed that the patient had the rectal metastasis of infiltrating ductal BC. CONCLUSION:Rectal metastasis should be considered when breast cancer patients present with a complaint of changed bowel habits, even for those with a history of ductal breast cancer.

scholarly journals Anal metastasis as the sentinel and isolated presentation of invasive ductal breast carcinoma

2016 ◽  
Vol 98 (5) ◽  
pp. e68-e70 ◽  
Author(s):  
C Rengifo ◽  
S Titi ◽  
J Walls
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Cancer Metastasis ◽  
Breast Cancer Metastasis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Invasive Ductal Breast Carcinoma ◽  
Ductal Breast Carcinoma ◽  
The Uk ◽  
Expanding Population

Breast cancer currently affects 1 in 8 women in the UK during their lifetime. Common sites for breast cancer metastasis include the axillary lymph nodes, bones, lung, liver, brain, soft tissue and adrenal glands. There is well documented evidence detailing breast metastasis to the gastrointestinal tract but anal metastasis is exceptionally rare. We present the case of a 78-year-old woman with an anal metastasis as the sentinel and isolated presentation of an invasive ductal breast carcinoma. As advances in the treatment of breast cancer improve, and with an ageing and expanding population, there will be an increasing number of cancer survivors, and more of these unusual presentations may be encountered in the future.

scholarly journals A rare case of isolated adrenal metastasis of invasive ductal breast carcinoma

2014 ◽  
Vol 142 (9-10) ◽  
pp. 597-601 ◽  
Author(s):  
Natasa Andjelic-Dekic ◽  
Ivana Bozovic-Spasojevic ◽  
Snezana Milosevic ◽  
Miodrag Matijasevic ◽  
Katarina Karadzic
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Computerized Tomography ◽  
Ductal Carcinoma ◽  
Radical Mastectomy ◽  
Histopathological Analysis ◽  
Adrenal Metastases ◽  
Invasive Ductal Breast Carcinoma ◽  
Ductal Breast Carcinoma ◽  
One Year

Introduction. Isolated adrenal metastases of invasive ductal breast carcinoma are extremely rare. We report a case with isolated left adrenal metastases, verified three years after diagnosed breast carcinoma. Case Outline. A 58-year-old female patient with a right breast tumor, clinically staged as IIIA (T2N2M0) started neoadjuvant anthracycline chemotherapy after biopsy which revealed invasive ductal breast carcinoma. Immunohistochemical findings of tumor biopsy showed hormonal steroid receptors for estrogen and progesterone negative, and human epidermal growth factor receptor 2 (HER2) positive. After 4 cycles of chemotherapy and partial tumor regression the patient underwent radical mastectomy. Definite histopathological analysis confirmed the diagnosis of invasive ductal carcinoma. The patient continued treatment with adjuvant chemotherapy to cumulative dose of anthracyclines, postoperative radiotherapy and adjuvant trastuzumab for one year. Three years later abdominal computerized tomography showed tumor in the left adrenal gland as the only metastatic site. Left adrenalectomy was performed and histopathological finding confirmed breast cancer metastases. Postoperatively, the patient received 6 cycles of docetaxel with trastuzumab and continued trastuzumab until disease progression. One year after left adrenalectomy control abdominal computerized tomography showed a right adrenal tumor with retroperitoneal lymphadenopathy. Treatment with capecitabine was continued for one year, but eventually she developed brain metastasis causing lethal outcome. Conclusion. In order to better understand metastatic pathways of invasive ductal breast carcinoma, publications of individual patient cases diagnosed with rare metastatic sites should be encouraged. This might improve our understanding of metastatic behavior of breast cancer and stimulate further clinical research.

Challenges in the correct assessment of a case of aggressive thyroid carcinoma with synchronous breast cancer, case report and review of the literature: essential role of radiopharmaceuticals

2020 ◽  
Vol 13 ◽  
Author(s):  
Andra Piciu ◽  
Alexandru Mester ◽  
George Rusu ◽  
Doina Piciu
Keyword(s):  
Breast Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Breast Carcinoma ◽  
Thyroid Carcinoma ◽  
Bone Metastases ◽  
Essential Role ◽  
Papillary Thyroid ◽  
Invasive Ductal Breast Carcinoma ◽  
Ductal Breast Carcinoma

Background: Thyroid carcinoma represents a complex pathology that can still be considered a medical challenge, despite having a better prognosis and life expectancy than most other neoplasms, also the scenario of multiple malignancies involving thyroid cancer is nowadays a common reality. Materials and methods: We reviewed the literature regarding the aggressive presentation of synchronous thyroid and breast cancer. In the current paper we are reporting the case of a 59 years-old woman, diagnosed with invasive ductal breast carcinoma and papillary thyroid carcinoma, presenting a natural history of both aggressive synchronous tumors. At the moment of hospitalization, the diagnostic was breast carcinoma with multiple secondary lesions, suggestive for lung and bone metastases, and nodular goiter. Results: Searching the literature PUBMED with the terms “thyroid carcinoma and synchronous breast carcinoma we found 86 studies; introducing the term “aggressive” the result included 4 studies, among them none being relevant for aggressive and synchronous. A similar search was done in SCOPUS finding 92 documents and after introducing the term aggressive, the number of papers was 8, none being for the synchronous aggressive metastatic thyroid and breast carcinoma. The majority of imaging diagnostic tools were used in this particular medical case, in order to ensure the best potential outcome. The final diagnostic was papillary thyroid carcinoma with lung and unusual multiple bone metastases and synchronous invasive ductal breast carcinoma with subcutaneous metastases. Conclusion: The case illustrates the challenges in correct assessment of oncologic patients, despite the advances in medical imaging and technologies and underlines the essential role of nuclear medicine procedures in the diagnostic and therapy protocols.

Local Recurrence of Breast Cancer after MammoSite® Brachytherapy

2006 ◽  
Vol 72 (9) ◽  
pp. 798-801
Author(s):  
Matthew Voth ◽  
Raye Budway ◽  
Angela Keleher ◽  
Philip F. Caushaj
Keyword(s):  
Breast Cancer ◽  
Treatment Plan ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Axillary Lymph ◽  
Ultrasound Guided ◽  
Breast Pathology ◽  
Poorly Differentiated ◽  
Her 2 ◽  
Negative Tumor

Women undergoing breast conservation therapy (BCT) for stage 1 breast cancer have adjuvant external beam radiotherapy (EBR). In addition, the use of brachytherapy radiation is being used. We present two local tumor recurrences for review. Our first patient underwent BCT, sentinel lymph node biopsy (SLNBx) and MammoSite® brachytherapy for a T1N0M0 infiltrating ductal carcinoma (IDC) of the right breast. Pathology: 0.6 cm poorly differentiated ER, PR, and Her-2/ Neu negative IDC. At 18 months, she had palpable axillary lymph nodes. Fine needle aspiration and ultrasound-guided core biopsy of a nodule showed IDC. She underwent modified radical mastectomy (MRM) and EBR. Our second patient underwent BCT, SLNBx, and MammoSite® brachytherapy for a T1N0M0 IDC of the left breast. Pathology: 0.8 cm poorly differentiated, ER+, PR-, and Her-2/Neu negative tumor. At 18 months, a retroareolar mass was detected. Ultrasound guided core needle biopsy showed recurrent IDC. She chose a re-excision and EBR and not MRM. Pathology: 1.3 cm poorly differentiated, ER+, PR-, and Her-2/Neu negative tumor. Our 2 recurrences were >2 cm away from the lumpectomy site and therefor outside the 1 cm treatment plan of the MammoSite® catheter. Both recurrences were biologically identical to the initial tumors and are felt to be local failures rather than new primaries.

Pneumonitis associated with Trastuzumab emtansine in a patient with metastatic breast cancer

2021 ◽  
pp. 107815522110660
Author(s):  
Muzaffer Uğraklı ◽  
Murat Araz ◽  
Aykut Demirkıran ◽  
Ahmet Faruk Çelik ◽  
Melek Karakurt Eryılmaz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fungal Infection ◽  
Metastatic Breast ◽  
Radical Mastectomy ◽  
Pulmonary Complications ◽  
Axillary Lymph ◽  
Trastuzumab Emtansine ◽  
Antibody Drug Conjugate ◽  
Drug Induced ◽  
Palpable Mass

Introduction Trastuzumab emtansine (TDM-1) is an antibody–drug conjugate effective in human epidermal growth factor receptor-2 - expressing advanced breast cancer. Pulmonary complications of TDM-1 are rarely reported. TDM-1-associated interstitial lung disease is referred to as pneumonitis. Case report A 47-year-old female patient who underwent modified radical mastectomy and axillary lymph node dissection operations due to a palpable mass in the right breast and axillary region. The patient who had received multiple chemotherapy was last receiving TDM-1 treatment. Fatigue, dyspnea, and tachypnea were detected for the first time on 20 days after the 6th treatment. Menagement and outcome In our case, we first considered metastasis, pneumonia and fungal infection based on radiological findings, but the lack of response to the treatments and the results of the investigations suggested drug-induced pneumonia and steroid treatment was started. Our case had a complete radiological recovery and complete response to sterod therapy. In such cases, it is important to first exclude infections and metastasis. In cases of drug-induced pneumonia, the first treatment option is systemic corticosteroids and generally responded well. Discussion Unlike other cases of interstitial pneumonia, lung imaging of our case was resembling a metastasis, pneumonia and fungal infection. With increasing use of TDM-1, we will have more experience in both efficacy and complications of TDM-1. Although TDM-1 is a well-tolerated drug, clinicians should be aware of rare pulmonary complications and prepared to respond appropriately.

scholarly journals A CROSS-SECTIONAL STUDY ON THE PREVALANCE AND RISK FACTORS OF LYMPHOEDEMA IN CARCINOMA BREAST

2017 ◽  
Vol 10 (6) ◽  
pp. 240
Author(s):  
Vishnu Gopal ◽  
Abhinabha Acharya ◽  
Vasudha Narayanaswamy ◽  
Santanu Pal
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Carcinoma ◽  
Upper Limb ◽  
Cancer Care ◽  
Postoperative Radiotherapy ◽  
Care Center ◽  
Locally Advanced ◽  
Significant Risk ◽  
Axillary Lymph

Objectives: Lymphedema of the arm is a devastating complication of breast carcinoma treatment. There is a lack of research on the risk factors and methods of preventing upper limb lymphedema after breast carcinoma treatment. The aims of the study are to identify the prevalence and risk factors for upper limb lymphedema in patients attending a tertiary cancer care center in India. Methods: 199 patients who attended the outpatient department of radiotherapy of IPGMER and SSKM, after undergoing surgical treatment for breast cancer between November 2014 to May 2016 were examined for the presence of lymphedema and its risk factors were analyzed. Lymphedema was defined as being present when there is an increase of >5% sum difference in the arm circumferences measured at different levels of both the upper limbs. Results: Of the 199 patients analyzed, 85 (42.7%) patients were found to have lymphedema. The prevalence of lymphedema was 25% in those who underwent surgery alone and 54% in those who underwent chest wall radiotherapy also. Locally advanced stage of the disease, body mass index >25 kg/m2, number of lymph nodes removed during surgery, and adjuvant radiotherapy were found to be significant risk factors for the development of lymphedema. Conclusion: Based on the results of this study, we recommend weight reduction and more judicious axillary lymph node dissection and use of postoperative radiotherapy as methods to prevent breast cancer-associated lymphedema in the tertiary cancer care centers in India.

scholarly journals Aggravated Primary Lymphedema of Contralateral Upper Limb after the Radical Mastectomy: A Case Report

2020 ◽  
Author(s):  
Ying Liu ◽  
Weiren Pan ◽  
Jinghong Guan ◽  
Xiao Long
Keyword(s):  
Breast Cancer ◽  
Upper Limb ◽  
Trauma Surgery ◽  
Radical Mastectomy ◽  
Axillary Lymph ◽  
Contralateral Limb ◽  
Case Presentation ◽  
Secondary Lymphedema ◽  
Primary Lymphedema ◽  
Lymphatic Development

Abstract Background: Breast cancer-related lymphedema is usually characterized by edema of the affected the ipsilateral upper limb and trunk. We report a case of aggravated primary lymphedema in the contralateral limb and trunk after breast cancer resection and axillary lymph node dissection.Case presentation: A 63-year-old female developed right thorax-back and upper limb swelling since childhood. After the modified mastectomy, the swelling of her right chest, back and upper limb increased. While she had no edema of left torso and limb. There was no relevant supplementary examination data because she refused to take lymphoscintigraphy or MRI scan. However, according to her medical history and physical examination, she was preliminarily diagnosed as primary lymphedema, International Society of lymphedema stage 2.Conclusions: Primary lymphedema and secondary lymphedema may be both results of the interaction of multiple factors and can be induced or aggravated by trauma, surgery or other reasons besides the abnormal lymphatic development of individuals.

scholarly journals EARLY COMPLICATIONS AFTER RADICAL OPERATIONS IN BREAST CANCER PATIENTS

2020 ◽  
Vol 1 ◽  
pp. 3-9
Author(s):  
Yuri Vinnyk ◽  
Vadym Vlasenko ◽  
Anna Baranova
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Wound Infection ◽  
Cancer Patients ◽  
Lymph Node Dissection ◽  
Early Period ◽  
Radical Mastectomy ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Node Dissection

Breast cancer is one of the most common malignancies in women. In many cases, a major component of complex treatment for breast cancer is surgery - radical mastectomy or radical breast resection. The aim of the work – to investigate the frequency and structure of complications after radical surgery with dissection of axillary lymph nodes in breast cancer patients. Material and methods. The baseline and surgical results of 147 women with breast cancer who underwent radical mastectomy or radical breast resection with lymph node dissection were analysed. Results. Complications in the early period after surgery for breast cancer were found in 76 (51.7 %), including postoperative extremity edema in 60 (40.8 %); lymphorrhea – in 37 (25.2 %), seroma – in 33 (22.4 %); wound infection in 18 (12.2 %), necrosis of the wound edges – in 15 (10.2 %) patients. Correlation of postoperative edema with almost all other complications was found, lymphorrhea and seroma were most associated with swelling and with each other; necrosis of edges with postoperative edema. Wound infection was significantly associated with lymphorrhea. Patients' age, stage of disease, and immunohistochemical type of tumour did not affect the development of complications. With increasing BMI, the incidence of complications increased significantly (χ2=9.530; p=0.009). The tendency to decrease the frequency of complications during reconstructive surgery was revealed (42.6 % versus 58.1 %, p=0.064), and adjuvant radiotherapy, on the contrary, contributed to the increase of complications (57.8 % versus 43.8 %, p=0.090). Conclusion. Radical operations with lymph node dissection in patients with breast cancer are characterized by a high frequency of early postoperative complications, mainly associated with disorders of lymphatic outflow, which indicates the need for a set of measures of preoperative preparation, improvement of surgical technique.

scholarly journals Atypical axillary lymphadenopathy mimicking an occult breast carcinoma in a patient diagnosed with sarcoidosis: case report

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Paula Clarke ◽  
Carolina Nazareth Valadares ◽  
Douglas de Miranda Pires ◽  
Nayara Carvalho de Sá
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Breast Lesions ◽  
Axillary Lymph ◽  
Axillary Lymphadenopathy ◽  
Granulomatous Lymphadenitis ◽  
Occult Breast Carcinoma

Introduction: Occult breast carcinoma is a rare presentation of breast cancer, with histological evidence of axillary lymph node involvement and clinical and radiological absence of malignant breast lesions. Its survival is similar to that of the usual presentation. The treatment consists of modified radical mastectomy or axillary drainage with breast irradiation, resulting in similar survival, associated with systemic therapy according to the staging. Neoadjuvant therapy should be considered in N2-3 axillary cases. Differential diagnoses of axillary lymphadenopathies include: non-granulomatous causes (reactive, lymphoma, metastatic carcinoma) and granulomatous causes (infectious – toxoplasmosis, tuberculosis, sarcoidosis, atypical mycobacteria). Objectives: To report the case of a patient who needed a differential diagnosis among the various causes of axillary lymphadenopathy. Methods: This is a literature review conducted in the PubMed database, using the keywords "granulomatous lymphadenitis", "breast sarcoidosis", "occult breast cancer". Inclusion and exclusion criteria were applied. Case report: V.F.S., female, 51 years old, was referred to an evaluation of axillary lymphadenopathy in May 2019. She was followed by the department of pulmonology due to mediastinal sarcoidosis since 2017. Physical examination indicated breasts without changes. Axillary lymph nodes had increased volume and were mobile and fibroelastic. Mammography revealed only axillary lymph nodes with bilaterally increased density, and the ultrasound showed the presence of atypical bilateral lymph nodes. Neither presented breast lesions. Axillary lymph node core biopsy was compatible with granulomatous lymphadenitis. This result corroborates the diagnosis of sarcoidosis affecting peripheral lymph nodes. The patient was referred back to the department of pulmonology, with no specific treatment since she is oligosymptomatic. Discussion: Despite the context of benign granulomatous disease, malignancy overlying the condition of sarcoidosis must be ruled out. The biopsy provided a safe and definitive diagnosis, excluding the possibility of occult breast carcinoma. The patient will continue to undergo breast cancer screening as indicated for her age and usual risk. Conclusion: In the presentation of axillary lymphadenopathy, the mastologist must know the various diagnoses to be considered. The most feared include lymphoma and carcinoma metastasis with occult primary site. A proper workup can determine the diagnosis and guide the appropriate treatment.

scholarly journals Role of axillary reverse mapping in decreasing complications after axillary dissection in breast cancer

2017 ◽  
Vol 4 (8) ◽  
pp. 2397 ◽  
Author(s):  
Ahmed Gaber ◽  
Ahmed Fawzy ◽  
Ahmed Sabry ◽  
Alaa El sisi
Keyword(s):  
Breast Cancer ◽  
Radical Mastectomy ◽  
Controlled Study ◽  
Blue Dye ◽  
Axillary Lymph ◽  
Axillary Reverse Mapping ◽  
Significant Difference ◽  
Complications Rate ◽  
And Control ◽  
Reverse Mapping

Background: Breast cancer is one of the most leading causes of cancer deaths in female. Surgical treatment is considered the corner stone in its management. Axillary lymph node dissection (ALND) is an integral step in most of surgeries done, however it has many morbidities like prolonged seroma and lymphedema. Axillary reverse mapping (ARM) procedure was first described in 2007 in a trial to map the axillary lymphatics of the arm and avoid its injury therefore lymph complications.Methods: A prospective, randomized, controlled study over 72 female patients who underwent modified radical mastectomy (MRM). Patients were divided and randomized into study and control groups, thirty-six patients for each. In study group the ARM procedure was done by injecting 2.5 ml of methylen blue dye intra-dermally and subcutaneously in the upper inner ipsilateral arm along the medial intramuscular groove before ALND. Operative and post-operative results were recorded. Follow up was 6 to 24 months.Results: ARM procedure and successful visualization of arm lymphatics was achieved in 31 patients (86.1%). Statistically there was no significant difference between the two groups regarding patient and tumour characteristics, operative time and number of excised L.Ns. There was significant difference favouring the ARM group in decreasing the incidence of seroma (p= 0.040), lymphedema (p= 0.031) and time passed till remove drains (p <0.001).Conclusions: ARM procedure facilitated arm lymphatics visualization. It is easy non-time-consuming procedure. It resulted in significant reduction in incidence of seroma and lymphedema, with considerable reduction in the overall complications rate.

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