Abstract: Gastrointestinal metastases from breast cancer are not common. We present a 58-year-old female diagnosed with lobular breast cancer some years before whose relapses were gastric and colonic mucosal. Simultaneous metastases are extremely rare. To our knowledge, no cases of initial dual affectation have been reported. The patient also showed gastritis by Helicobacter pylori. Invasive lobular breast carcinoma is the most frequent special type of breast cancer and carries some specific molecular alterations such as loss of expression of E-cadherin. Although underlying mechanisms of metastasization are not entirely known, chemokines as well as inflammatory events seem to be implicated in this process. Interaction between chemokines and their receptors frequently induces cell migration. We hypothesize that H. pylori, inflammatory cells, and chemokines may create a favorable environment attracting tumor cells.
Keywords: chemokines, gastrointestinal metastases, H. pylori, lobular carcinoma
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INTRODUCTION
Breast cancer is the most frequent malignancy among women. Approximately 16,000 new cases are diagnosed each year in Spain. The 5-year survival rate is constantly increasing, which implies a growing prevalence in almost all developed countries. Modern adjuvant treatment regimens have yielded a reduction in relapses and higher cure rates.
Relapses have been reported in 30%–80% of patients in spite of surgery, chemotherapy, and radiotherapy, but are rare in early-stage breast cancer.1 The most common sites of distant metastases are in bone, liver, lung, and brain.
Lobular carcinoma is less likely to involve the gastrointestinal tract. The incidence of extrahepatic gastrointestinal tract metastases observed in autopsy studies varies from 4% to 18%, with the most commonly affected organ being the stomach, followed by colon and rectum.2,3 Nevertheless, coexisting solitary metastases to both stomach and colon are extremely rare.
