Abstract
The metastasis of breast cancer to the colon is a rare occurrence, especially in the presence of changes in estrogen and progesterone receptors. To date, literature has only reported two cases of invasive ductal carcinoma and two cases of invasive lobular carcinoma metastasizing to the colon with concurrent changes in hormone receptors. This report describes a 65-year-old woman with a history of left breast cancer, who presented with symptoms of bloody stools and abdominal pain. CT and colonoscopy results revealed a malignant tumor in the ascending colon, and the patient underwent surgery. Pathological results post-surgery indicated changes in hormone receptors, differing from the previous breast cancer pathology, ultimately leading to the diagnosis of breast cancer metastasis to the colon. The patient was found to have liver metastasis 14 months after right hemicolectomy, and systemic metastases in various locations were discovered at the 19-month mark.
Introduction
Breast cancer is the most common malignant tumor in women. Recurrence and distant metastasis often pose challenges in treatment. Common sites of metastasis include bones, liver, and lungs, while gastrointestinal metastases are extremely rare. Previous reports have shown that the pattern of metastasis differs between lobular carcinoma and ductal carcinoma of the breast. Gastrointestinal, gynecologic, and peritoneal metastases are more common in lobular carcinoma (1, 2). ILC (invasive lobular carcinoma) has an increased tendency to metastasize to the GI (gastrointestinal) tract compared with breast carcinomas of NST (non-special type) (40% vs. 2%) (3). We report a case of infiltrating ductal carcinoma that metastasized to the ascending colon, with changes in estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2) status. To our knowledge, there have been only two similar cases reported previously.
Case presentation
A 65-year-old woman presented to our center with intermittent abdominal pain and hematochezia for several months. She had a previous diagnosis of ER- and PR-positive (Figure 1), HER2 ++ (no further testing was done) invasive ductal carcinoma of the left breast 5 years before. She underwent modified radical mastectomy for breast cancer. The pathological examination did not indicate the presence of axillary lymph node metastasis and received chemotherapy with anthracycline and cyclophosphamide, followed by taxanes. Subsequently, she received 5 years of endocrine therapy with letrozole until she presented to our center. The patient denied having smoked or consumed alcohol in the past.
Figure 1
During colonoscopy, a mass was found in the ascending colon (Figure 2). Biopsy results confirmed metastasis of breast cancer to the colon, which was negative for ER, PR, and HER2. However, no local lesions or enlarged lymph nodes were detected in the contralateral breast, chest wall, or axilla through ultrasound, magnetic resonance imaging, and clinical palpation.
Figure 2
After receiving a transfusion of six units of red blood cells to correct anemia, the patient underwent a right hemicolectomy. Intraoperatively, it was observed that the tumor had invaded the right renal fascia. Two lymph node metastases were found on pathological examination after palliative surgery for colonic malignancy. The postoperative pathological examination confirmed the colonoscopy biopsy findings. Further immunohistochemical staining revealed positive results for Cytokeratin 7 (CK7), negative results for Cytokeratin 20 (CK20), and positive results for GATA 3 binding protein (GATA3) and E-Cadherin (Figure 3).
Figure 3
Considering the rarity of this case, we sought opinions from pathologists in different centers to confirm the diagnosis. After considering the majority of expert opinions, it was confirmed as breast cancer metastasis to the colon. The patient was prescribed oral capecitabine at a dosage of 650-mg/m2 twice daily for chemotherapy treatment.
Follow-up imaging studies performed 6 months after the operation did not show any tumor metastasis or recurrence. However, the patient discontinued medication due to severe hand–foot syndrome. In a 14-month postoperative computed tomography (CT) scan, a solitary nodule was detected in the liver, indicating a metastatic lesion (Figure 4). The patient refused intravenous chemotherapy and opted for a second course of oral capecitabine treatment. Nineteen months after surgery, multiple metastases were discovered, including the liver, abdominal lymph nodes, adrenal glands, thoracolumbar spine, lungs, and mediastinal lymph nodes, accompanied by widespread cancer-related pain. The patient declined medication treatment. During the entire follow-up, no local recurrence of breast malignancy or new tumors of the opposite breast were found. The patient was lost to follow-up at 20 months after right hemicolectomy. Treatment and follow-up are organized into a timeline (Figure 5).
Figure 4
Figure 5
Discussion
Breast cancer metastases to the gastrointestinal tract is extremely rare. Previous reports have shown that the most common sites of metastases in breast cancer are the bones, lungs, liver, and brain, while gastrointestinal metastases, especially to the colon, is very rare. The incidence of breast cancer metastases to the gastrointestinal tract, particularly to the colon, is estimated to be around 1%, with a rate of approximately 0.1% specifically for metastases to the colon (4). The patterns of metastases differ between lobular carcinoma and ductal carcinoma of the breast, with gastrointestinal metastases being more common in lobular carcinoma (1, 2). In this case, it was the ductal carcinoma of the breast that had colon metastases.
Due to the final diagnosis of breast cancer metastasis to the colon with receptor changes, this case presents significant challenges in terms of diagnosis and treatment. We performed a search in the PubMed database and gathered relevant literature, as detailed in Table 1. Our findings reveal the fourth documented case of ductal carcinoma of breast metastasizing to the colon, accompanied by changes in receptor status. Additionally, there have been two cases where receptor changes were observed when lobular carcinoma metastasized to the colon (5, 6).
Table 1
| Author | Year | Age | Primary(breast) | Treatment | Time since first diagnosis (years) | Metastasis | |||
|---|---|---|---|---|---|---|---|---|---|
| Site | Pathological types | Biomarkers | Site | Biomarkers | |||||
| Takeuchi H (18) | 2012 | 38 | left | ILC | ER+,PR-,HER2- | Surgery, Chemotherapy, Radiation therapy, Endocrine Therapy | 3 | Stomach and Colon | ER+,PR-, HER2- - |
| Jansen van Rensburg A (19) | 2021 | 74 | left | DC | ER+,PR- | Surgery, Radiation therapy, Endocrine Therapy | 27 | Bone,ovary, sigmoid colon | ER +, PR+ E-cadherin+, GATA3+,CK20- |
| Sheen-Chen SM (20) | 2008 | 41 | right | IDC | – | – | Simultaneous | ovary and omentum | - CK7+、CEA+、CK20- |
| Higley C (21) | 2020 | 74 | right | – | – | breast-conserving surgery and radiation therapy, Endocrine Therapy | 40 | transverse colon. | ER-、PR-、HER2- CDX-2-、CK20-、GATA3+、E-cadherin-、PD-L1- |
| Khan I (22) | 2017 | 56 | right | ring cell adenocarcinoma | – | – | Simultaneous | stomach, small intestine, and colon | – |
| Noor A (23) | 2020 | 68 | – | ILC | ER+,PR+,HER2- | Surgery, Radiation therapy, Endocrine Therapy | 30 | Bone、sigmoid colon | ER+、PR+、HER2-,CK7+, CK20-,CDX2-,CA19-9- |
| Bering J (5) | 2020 | 67 | left | ILC | ER+,PR+,HER2- | Endocrine Therapy | Simultaneous | transverse colon | ER-,PR-,HER2+ GATA3+,CK7+,CDX2-,CK20-,E-cadherin-,GCDFP-15+ |
| Abid A (24) | 2013 | 59 | left | LC | ER+,PR+,HER2- | – | Simultaneous | stomach, duodenum, and colon | ER+、PR+ GCDFP-15+ |
| Takedomi H (4) | 2019 | 76 | right | ILC | – | Chemotherapy | Simultaneous | descending colon | - GCDFP-15+,mammaglobin+ |
| Abu Zaanona MI (25) | 2020 | 73 | – | – | – | Endocrine Therapy | – | colon | ER+,PR-,HER2-,Pancytokeratin+, GATA3 +, E-cadherin-, CDX2-, SOX10- |
| Inoue H (26) | 2022 | 63 | right | Chemotherapy,Endocrine Therapy | 15 | ER+,PR-,HER2+,CK7+, GATA3+, ER+, HER2+, CK20-, PR-, E-cadherin-, GCDFP15- ,caudal-related homeobox 2 | |||
| Mostafa A (27) | 2002 | 56 | – | IDC | ER+,PR+ | Surgery, Radiation therapy, Endocrine Therapy | 5 | descending colon | ER-,PR-- |
| Tsujimura K (28) | 2017 | 51 | left | ILC | ER+,PR+ | – | Simultaneous | ileocecal | ER+,PR+,HER2- |
| Feng CL (29) | 2009 | 49 | right | IDC | – | – | 2 | Colon | CK7+, CK20- |
| Kobayashi M (30) | 2020 | 74 | – | ILC | – | surgery | 23 | stomach and colon | CAM5.2+,ER+, E-cadherin- |
| Théraux J (31) | 2008 | 69 | bilateral | IDC | – | Surgery, Endocrine Therapy | 28 | transverse colon | ER+,PR+, HER2-, CK7+, CK20- |
| Malhotra A (32) | 2009 | 71 | – | – | – | – | – | bone, transverse colon | – |
| Villa Guzmán JC (33) | 2017 | 58 | – | ILC | ER+,PR+,HER2- | Surgery, Chemotherapy, Radiation therapy, Endocrine Therapy | 3 | stomach | cytokeratin-19+,ER+ |
| Gerova VA (34) | 2012 | 56 | left | ILC | PR+ | Surgery, Chemotherapy, Radiation therapy, Endocrine Therapy | 5 | stenotic, stomach | – |
| 42 | left | – | ER+,PR+ | Surgery, Chemotherapy, Radiation therapy, Endocrine Therapy | 7 | stomach | ER+,PR+,CK7+, E-cadherin+,S-100+, GCFP15-,CDX2- | ||
| Wang G (35) | 2014 | 70 | left | IDC | E-cadherin+、34βE12-、ER+、PR+、CK19+、CK20+ | Surgery, Radiation therapy, Endocrine Therapy | 10 | ascending colon | CK7+、E-cadherin+、34βE12-、ER+、GCDFP-15+、CK19+、CK20+ |
| Cho DH (36) | 2011 | 46 | bilateral | IDC | ER+,PR+,HER2- | Surgery, Chemotherapy, Radiation therapy, Endocrine Therapy | 2 | terminal ileum | ER+,PR-,HER2+, |
| Algethami NE (37) | 2022 | 47 | bilateral | ILC | ER+,PR+,HER2- | Surgery, Radiation therapy, Endocrine Therapy | 4 | rectum | ER+、HER2+、Pan-cytokeratin + |
| Zhou XC (38) | 2012 | 54 | right | IDC | ER+,PR+,P53+, HER2- | Surgery, Chemotherapy, Radiation therapy, Endocrine Therapy | 8 | sigmoid colon | CDX2-, Villin-, TTF-1-, -CK20-, HER2-, ER- ,PR-, CK7+,p53+ |
| Andriola V (39) | 2014 | 63 | left | IDC,LC | – | Surgery, Chemotherapy, Radiation therapy, Endocrine Therapy | 23 | colon and terminal ileum | CK19+, GCFDP-15+,HER2+ |
| Motos-Micó J (40) | 2014 | 69 | right | ILC | – | Surgery, Chemotherapy | 18 | sigmoid colon | ER-,PR-,HER2-,CK7+ |
| Abdallah H (41) | 2020 | 59 | right | ILC | ER+,PR+,HER2- | – | Simultaneous | endometrium, myometrium, fibroid and cervix | CK7+,GATA3+,ER+,PR+, desmin-, CD10-, actin- ,Caldesmon- |
| 66 | right | ILC | CK+,ER+,PR+,HER2- | – | Simultaneous | Colon | CK7+,GATA-3+,ER+,CK20-,CDX2- | ||
| 53 | right | ILC | – | – | Simultaneous | intestine, omentum, and peritoneal wall, bilateral ovarian, stomach | CK7+、GATA-3+,ER+,E-cadherin+,CK20-,CDX2- | ||
| Michalopoulos A (42) | 2004 | 55 | left | IDC | – | Surgery, Chemotherapy | 4 | transverse colon | CK7+,milk-fat globule protein+, |
| 57 | left | ILC | – | Surgery, Chemotherapy, Radiation therapy | 10 | transverse colon | CK7+,milk-fat globule protein+, CEA+,ER+, weakly positive for cytokeratin 20 and Breast II. | ||
| Schellenberg AE (43) | 2018 | 69 | left | IDC | E-cadherin+,ER+,PR+,HER2+ | Surgery, Chemotherapy, Radiation therapy, Endocrine Therapy | 2 | rectosigmoid | CK-7+, E-cadherin+, GCDFP+, mammoglobin+,ER+,PR+,CK-20-,CDX-2-- |
| Matsuda I (44) | 2012 | 62 | left | ILC | – | Surgery | 24 | ascending colon and rectum | CK7+,ER+,CK20-,E-cadherin- |
| Koleilat I (45) | 2010 | 54 | right | IDC | – | Surgery, Chemotherapy, Radiation therapy, Endocrine Therapy | 13 | colon | ER+,PR+,HER2- |
| Mistrangelo M (46) | 2011 | 80 | left | ILC | – | Surgery, Endocrine Therapy | 25 | sigmoid colon | – |
| Razzetta F (47) | 2011 | 77 | bilateral | ILC(left),IDC(right) | – | – | Simultaneous | right, transverse and left colon | ER+,PR- |
| Cervi G (48) | 2001 | 59 | – | ILC | – | Surgery | 8 | rectum | ER+,PR+ |
| Amin AA (49) | 2011 | 61 | right | ILC | – | Surgery, Endocrine Therapy | 17 | rectum | CK 20-,ER+,CK7+,PR+ |
| López Deogracias M (6) | 2009 | 67 | left | ILC | ER+,PR+ | Surgery | 15 | rectum | ER-,PR-,CK20-,CDX2- |
| Law WL (50) | 2003 | 49 | left | IDC | ER+ | Surgery, Endocrine Therapy | 5 | descending colon | ER+ |
| Samra B (51) | 2019 | 64 | – | – | – | – | – | colon,right sacral iliac | CK-7+,GATA-3+,ER+,MOC31+,CK-20-,CD-X2-,PR-,PAX-8-,SOX-10-,CD4-5,chromogranin-, synaptophysin-, TTF-1- |
| Kim HW (52) | 2014 | 46 | right | metaplastic | ER-,PR-,HER2- | Surgery, Chemotherapy, Radiation therapy | 2 | sigmoid colon | CK20-,CK5/6-,ER-,PR-,HER2-,CK7+ |
| Signorelli C (53) | 2005 | 62 | right | ILC | – | Surgery | 12 | right chest wall, colon | ER+,PR+,P53-,HER2- |
| Gizzi G (54) | 2015 | 72 | – | – | ER+,PR+ | Surgery, Chemotherapy, Radiation therapy, Endocrine Therapy | 11 | sigmoid colon | CK7+,GATA3+, ER+,PR+,HER2- |
| Dhar S (55) | 2003 | 75 | left | – | ER+ | Surgery | 6 | sigmoid colon | ER+,CK7+,CK20- |
| Maekawa H (56) | 2012 | 52 | right | IDC | ER+,PR+ | Surgery, Chemotherapy, Radiation therapy, Endocrine Therapy | 16 | ascending colon | – |
| Koufopoulos N (57) | 2018 | 87 | – | – | – | – | – | Colonic serosa | CK-20-,CDX-2-,CK7-,r GATA-3+, mammaglogin+,ER+,PR+, E-cadherin-, Chromogranin-,synaptophysin- |
| Critchley AC (58) | 2011 | 62 | – | IDC | – | Surgery, Chemotherapy, Radiation therapy, Endocrine Therapy | 8 | stomach, ascending colon | ER+,PR+,HER2-,CK7+,CK20- |
| Kachi A (59) | 2019 | 58 | left | ILC | – | Surgery, Chemotherapy, Radiation therapy, Endocrine Therapy | 6 | sigmoid colon, appendix, and ovaries. | ER+,PR+ |
| Blachman-Braun R (60) | 2018 | 73 | bilateral | – | – | Surgery, Chemotherapy, | 15 | colon | ER+,PR-,HER2- |
| Jia J (61) | 2023 | 67 | right | IDC | ER+,PR+,HER2- | Surgery, Chemotherapy, Endocrine Therapy | 10 | Appendix, colon | GATA-3+,GCDFP-15+,ER+,PR+,HER2+, E-cadherin+,p120+,CK7+,CK20-,SATB-2-,Villin-,syn-,CgA-,CD56- |
| Arif FZ (62) | 2023 | 65 | bilateral | IDC | triple-negative (left), HER2+(right) | – | – | descending colon | – |
Case reports of breast carcinomas with colonic metastases.
ILC, Invasive lobular carcinoma; IDC, Invasive ductal carcinoma; DC, ductal carcinoma; LC, lobular carcinoma; ER, estrogen receptor; PR, progesterone receptor; HER2, human epidermal growth factor receptor-2; CK7, Cytokeratin 7; CK20, Cytokeratin 20; GATA3, GATA 3 binding protein. CEA, Carcinoembryonic antigen; CDX2, caudal-related homeobox transcription factor 2; GCDFP, Gross cystic disease fluid protein; CAM5.2, cytokeratin CAM5.2; S-100, closely related, small, acidic Ca2+-binding proteins; 34βE12, cytokeratin 34βE12; P53, tumour suppressor gene p53; PAX-8, a nephric cell lineage transcription factor; SOX-10, SRY-related HMG-box 10; CD45, receptor-like protein tyrosine phosphatase; TTF-1, Thyroid transcription factor 1; CK5/6, cytokeratin 5/6; p120, p120-catenin; SATB-2, special AT-rich sequence-binding protein 2; syn, Synuclein; CgA, Chlorogenic acid; CD56, Neural cell adhesion molecule; SOX10, transcription factors SOX10.
In this case, there was a mismatch between the receptors in the primary breast lesion and the colon metastases. Incompatible receptors between the primary and secondary lesions of breast cancer have been reported, with frequencies of alterations in ER, PR, and HER2 being approximately 16.4%–32.4%, 30.9%–37.78%, and 10.2%–14.5%, respectively (7–10). Emilia Montagna reported in 2017 that approximately 82% of breast cancer metastases in the gastrointestinal tract have positive hormone receptor expression (11). In the dozens of case reports we have collected, the majority of patients were found to be hormone receptor positive. Among these patients, most did not exhibit any changes in the hormone receptor status. Previous reports have indicated that the instability of hormone receptors in breast cancer is associated with a poorer prognosis (12, 13), Women whose ER-positive primary tumors transform into ER-negative tumors experience a significant 48% increase in the risk of death (7). In this case report, liver metastases were found at 14 months after surgery, and multiple metastases throughout the body were found at 19 months with subsequent rapid disease progression.
CK7, CK20, and GATA3 are commonly used in pathology for tumor diagnosis and classification. These markers can provide information about the type and origin of the tumor. CK7 was expressed in 89%–98% of non-specified breast cancers (14). Most gastrointestinal, pancreaticobiliary, and ovarian mucinous adenocarcinomas are CK20 positivity, in adenocarcinoma, positivity of CK20 strongly indicates a non-breast origin, and CK7−/CK20+ immunoprofile strongly suggests colorectal origin (15). Based on previous research reports, CK7+/CK20 should be considered indicative of a tumor originating from the breast. GATA3 is also thought to be often positive in primary breast disease (16, 17). It was based on the immunohistochemical staining results of CK7 positive, CK20 negative, and GATA3 positive, combined with the opinions of multicenter pathologists, showing that the case was finally diagnosed as breast cancer with colon metastasis. Even though this case is very rare, we should still pay attention to the occurrence of colon metastasis in the diagnosis and treatment of breast cancer.
Conclusions
This case serves as a reminder to clinicians that they should consider rare sites of metastases and different receptor expression patterns in breast cancer patients in order to make more accurate treatment decisions. However, further research is needed to explore the mechanisms of this metastatic pattern and related treatment strategies.
Statements
Data availability statement
The datasets presented in this article are not readily available due to participant privacy. Requests to access the datasets should be directed to the corresponding authors.
Ethics statement
The studies involving humans were approved by Ethics Review Committee of Southern Central Hospital of Yunnan Province. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.
Author contributions
HL: Investigation, Resources, Writing – original draft, Writing – review & editing. LY: Investigation, Writing – original draft. XS: Investigation, Writing – original draft. GL: Investigation, Writing – original draft. WG: Resources, Writing – original draft. FM: Writing – review & editing. ZW: Writing – review & editing. SQ: Writing – review & editing. CL: Writing – review & editing.
Funding
The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The present study was supported by the Scientific Research Project of Southern Central Hospital of Yunnan Province (grant no.KY202401).
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher’s note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
References
1
BorstMJIngoldJA. Metastatic patterns of invasive lobular versus invasive ductal carcinoma of the breast. Surgery. (1993) 114:637–41; discussion 641-2.
2
KenneckeHYerushalmiRWoodsRCheangMCVoducDSpeersCHet al. Metastatic behavior of breast cancer subtypes. J Clin Oncol. (2010) 28:3271–7. doi: 10.1200/JCO.2009.25.9820
3
KioleoglouZGeorgakiEKoufopoulosNKostekOVolakakisNDimitriadouAet al. Gastrointestinal metastases from lobular breast carcinoma: A literature review. Cureus. (2024) 16:e65852. doi: 10.7759/cureus.65852
4
TakedomiHAkutagawaTSakataY. Colon metastasis of breast cancer with a unique endoscopic finding. Clin Gastroenterol Hepatol. (2020) 18:e74. doi: 10.1016/j.cgh.2019.04.014
5
BeringJRyanMGuruduSR. Breast cancer metastasis presenting as colonic polyps. ACG Case Rep J. (2020) 7:e00411. doi: 10.14309/crj.0000000000000411
6
López DeograciasMFlores JaimeLArias-CamisónIZamacolaIMurillo GuibertJSuescun GarcíaRet al. Rectal metastasis from lobular breast carcinoma 15 years after primary diagnosis. Clin Transl Oncol. (2010) 12:150–3. doi: 10.1007/S12094-010-0481-0
7
LindströmLSKarlssonEWilkingUMJohanssonUHartmanJLidbrinkEKet al. Clinically used breast cancer markers such as estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 are unstable throughout tumor progression. J Clin Oncol. (2012) 30:2601–8. doi: 10.1200/JCO.2011.37.2482
8
MatsumotoAJinnoHMurataTSekiTTakahashiMHayashidaTet al. Prognostic implications of receptor discordance between primary and recurrent breast cancer. Int J Clin Oncol. (2015) 20:701–8. doi: 10.1007/s10147-014-0759-2
9
YangZLiNLiXLeiLWangX. The prognostic impact of hormonal receptor and HER-2 expression discordance in metastatic breast cancer patients. Onco Targets Ther. (2020) 13:853–63. doi: 10.2147/OTT.S231493
10
ZhaoWSunLDongGWangXJiaYTongZ. Receptor conversion impacts outcomes of different molecular subtypes of primary breast cancer. Ther Adv Med Oncol. (2021) 13:17588359211012982. doi: 10.1177/17588359211012982
11
MontagnaEPirolaSMaisonneuvePDe RobertoGCancelloGPalazzoAet al. Lobular metastatic breast cancer patients with gastrointestinal involvement: features and outcomes. Clin Breast Cancer. (2018) 18:e401–401e405. doi: 10.1016/j.clbc.2017.07.003
12
YangYFLiaoYYYangMPengNFXieSRXieYF. Discordances in ER, PR and HER2 receptors between primary and recurrent/metastatic lesions and their impact on survival in breast cancer patients. Med Oncol. (2014) 31:214. doi: 10.1007/s12032-014-0214-2
13
YamanouchiKKubaSEguchiS. Hormone receptor, human epidermal growth factor receptor-2, and Ki-67 status in primary breast cancer and corresponding recurrences or synchronous axillary lymph node metastases. Surg Today. (2020) 50:657–63. doi: 10.1007/s00595-019-01831-8
14
LuSYakirevichEWangLJResnickMBWangY. Cytokeratin 7-negative and GATA binding protein 3-negative breast cancers: Clinicopathological features and prognostic significance. BMC Cancer. (2019) 19:1085. doi: 10.1186/s12885-019-6295-8
15
LerwillMF. Current practical applications of diagnostic immunohistochemistry in breast pathology. Am J Surg Pathol. (2004) 28:1076–91. doi: 10.1097/01.pas.0000126780.10029.f0
16
GownAMFultonRSKandalaftPL. Markers of metastatic carcinoma of breast origin. Histopathology. (2016) 68:86–95. doi: 10.1111/his.12877
17
DaviesTChouariTRayCElgammalS. Appendiceal adenocarcinoma with breast metastases. BMJ Case Rep. (2021) 14. doi: 10.1136/bcr-2020-240808
18
TakeuchiHHiroshigeSYoshikawaYKusumotoTMutoY. A case of synchronous metastasis of breast cancer to stomach and colon. Anticancer Res. (2012) 32:4051–5.
19
Jansen van RensburgARiddellA. A case report of ductal carcinoma of the breast metastasizing to the bowel. J Surg Case Rep. (2021) 2021:rjab471. doi: 10.1093/jscr/rjab471
20
Sheen-ChenSMLiuYWSunCKLinSEEngHLHuangWTet al. Abdominal carcinomatosis attributed to metastatic breast carcinoma. Dig Dis Sci. (2008) 53:3043–5. doi: 10.1007/s10620-008-0529-y
21
HigleyCHsuAParkBUPangM. Back to basics: history and physical examination uncover colonic metastasis in a patient with remote history of breast cancer. ACG Case Rep J. (2020) 7:e00494. doi: 10.14309/crj.0000000000000494
22
KhanIMalikRKhanAAssadSZahidMSohailMSet al. Breast cancer metastases to the gastrointestinal tract presenting with anemia and intra-abdominal bleed. Cureus. (2017) 9:e1429. doi: 10.7759/cureus.1429
23
NoorALopetegui-LiaNDesaiAMesologitesTRathmannJ. Breast cancer metastasis masquerading as primary colon and gastric cancer: A case report. Am J Case Rep. (2020) 21:e917376. doi: 10.12659/AJCR.917376
24
AbidAMoffaCMongaDK. Breast cancer metastasis to the GI tract may mimic primary gastric cancer. J Clin Oncol. (2013) 31:e106–7. doi: 10.1200/JCO.2012.44.6393
25
Abu ZaanonaMIGulatiARowlandK. Colon metastases as first clinical manifestation of lobular breast carcinoma with no subsequent evidence of breast disease. BMJ Case Rep. (2020) 13. doi: 10.1136/bcr-2020-236225
26
InoueHAritaTKuriuYShimizuHKiuchiJYamamotoYet al. Colonic metastasis from breast cancer: A case report and review of the literature. In Vivo. (2022) 36:522–7. doi: 10.21873/invivo.12733
27
MostafaACarpenterR. Colonic metastasis from a breast cancer a case report and a few questions. Eur J Surg Oncol. (2002) 28:462. doi: 10.1053/ejso.2002.1174
28
TsujimuraKTeruyaTKiyunaMHigaKHigaJIhaKet al. Colonic metastasis from breast carcinoma: a case report. World J Surg Oncol. (2017) 15:124. doi: 10.1186/s12957-017-1193-5
29
FengCLChouJWHuangSF. Colonic metastasis from carcinoma of the breast presenting with colonic erosion. Endoscopy. (2009) 41 Suppl 2:E276–7. doi: 10.1055/s-0029-1215066
30
KobayashiMTashimaTNagataKSakuramotoSOsakiARyozawaS. Colorectal and gastric metastases from lobular breast cancer that resembled superficial neoplastic lesions. Clin J Gastroenterol. (2021) 14:103–8. doi: 10.1007/s12328-020-01285-3
31
ThérauxJBretagnolFGuedjNCazals-HatemDPanisY. Colorectal breast carcinoma metastasis diagnosed as an obstructive colonic primary tumor. A case report and review of the literature. Gastroenterol Clin Biol. (2009) 33:1114–7. doi: 10.1016/j.gcb.2009.05.015
32
MalhotraAGuturuPBasimMSRajuGS. A rare case of breast cancer metastasis presenting as linitis plastica of the stomach and colon (with videos). Gastrointest Endosc. (2009) 70:552–3; discussion 553. doi: 10.1016/j.gie.2009.04.029
33
Villa GuzmánJCEspinosaJCerveraRDelgadoMPatónRCordero GarcíaJM. Gastric and colon metastasis from breast cancer: case report, review of the literature, and possible underlying mechanisms. Breast Cancer (Dove Med Press). (2017) 9:1–7. doi: 10.2147/BCTT.S79506
34
GerovaVATankovaLTMihovaAADrandarskaILKadianHO. Gastrointestinal metastases from breast cancer: report of two cases. Hepatogastroenterology. (2012) 59:178–81. doi: 10.5754/hge10681
35
WangGWangTJiangJZhouLZhaoH. Gastrointestinal tract metastasis from tubulolobular carcinoma of the breast: a case report and review of the literature. Onco Targets Ther. (2014) 7:435–40. doi: 10.2147/OTT.S57831
36
ChoDHJeonYSChoiMYLeeSKKimSMHurSMet al. Ileal metastasis of breast cancer in a patient with a BRCA2 gene mutation: report of a case. Surg Today. (2011) 41:1665–9. doi: 10.1007/s00595-011-4503-5
37
AlgethamiNEAlthagafiAAAloufiRAAl ThobaitiFAAbdelazizHA. Invasive lobular carcinoma of the breast with rectal metastasis: A rare case report. Cureus. (2022) 14:e23666. doi: 10.7759/cureus.23666
38
ZhouXCZhouHYeYHZhangXFJiangY. Invasive ductal breast cancer metastatic to the sigmoid colon. World J Surg Oncol. (2012) 10:256. doi: 10.1186/1477-7819-10-256
39
AndriolaVPiscitelliDDe FazioMAltomareDF. Massive colonic metastasis from breast cancer 23 years after mastectomy. Int J Colorectal Dis. (2015) 30:427–8. doi: 10.1007/s00384-014-1992-x
40
Motos-MicóJFerrer-MárquezMBelda-LozanoRReina-DuarteÁRosado-CobiánR. Metastasis of lobular breast carcinoma in the sigmoid colon. Rev Esp Enferm Dig. (2014) 106:366–7.
41
AbdallahHElwyAAlsayedARabeaAMagdyN. Metastatic breast lobular carcinoma to unusual sites: A report of three cases and review of literature. J Med Cases. (2020) 11:292–5. doi: 10.14740/jmc3538
42
MichalopoulosAPapadopoulosVZatagiasAFahantidisEApostolidisSHaralabopoulosEet al. Metastatic breast adenocarcinoma masquerading as colonic primary. Report of two cases. Tech Coloproctol. (2004) 8 Suppl 1:s135–7. doi: 10.1007/s10151-004-0135-8
43
SchellenbergAEWoodMLBaniakNHayesP. Metastatic ductal carcinoma of the breast to colonic mucosa. BMJ Case Rep. (2018) 2018. doi: 10.1136/bcr-2018-224216
44
MatsudaIMatsubaraNAoyamaNHamanakaMYamagishiDKunoTet al. Metastatic lobular carcinoma of the breast masquerading as a primary rectal cancer. World J Surg Oncol. (2012) 10:231. doi: 10.1186/1477-7819-10-231
45
KoleilatISyalAHenaM. Metastatic male ductal breast cancer mimicking obstructing primary colon cancer. Int J BioMed Sci. (2010) 6:66–70. doi: 10.59566/IJBS.2010.6066
46
MistrangeloMCassoniPMistrangeloMCastellanoICodognottoESapinoAet al. Obstructive colon metastases from lobular breast cancer: report of a case and review of the literature. Tumori. (2011) 97:800–4. doi: 10.1177/030089161109700619
47
RazzettaFTassaraESaroFSironiMD’AmbrosioG. Rare abdominal metastases from occult lobular breast cancer: report of two cases. Updates Surg. (2011) 63:129–33. doi: 10.1007/s13304-011-0047-x
48
CerviGVettorettoNVincoACerviEVillanacciVGrigolatoPet al. Rectal localization of metastatic lobular breast cancer: report of a case. Dis Colon Rectum. (2001) 44:453–5. doi: 10.1007/BF02234749
49
AminAAReddyAJhaMPrasadK. Rectal metastasis from breast cancer: an interval of 17 years. BMJ Case Rep. (2011) 2011. doi: 10.1136/bcr.01.2011.3683
50
LawWLChuKW. Scirrhous colonic metastasis from ductal carcinoma of the breast: report of a case. Dis Colon Rectum. (2003) 46:1424–7. doi: 10.1007/s10350-004-6762-3
51
SamraBGhanemSIlyasGTaiwoE. Screening colonoscopy unmasking colonic metastasis from an occult breast ductal carcinoma: A case report and review of the literature. Case Rep Oncol Med. (2019) 2019:8432079. doi: 10.1155/2019/8432079
52
KimHWMoonDH. Sigmoid colon metastasis from metaplastic breast carcinoma mimicking primary sigmoid colon cancer. Rev Esp Med Nucl Imagen Mol. (2015) 34:211–2. doi: 10.1016/j.remn.2014.09.002
53
SignorelliCPomponi-FormiconiDNelliFPolleraCF. Single colon metastasis from breast cancer: a clinical case report. Tumori. (2005) 91:424–7. doi: 10.1177/030089160509100509
54
GizziGSantiniDGuidoAFuccioL. Single colonic metastasis from breast cancer 11 years after mastectomy. BMJ Case Rep. (2015) 2015:bcr2015211193. doi: 10.1136/bcr-2015-211193
55
DharSKulaylatMNGordonKLallPDoerrRJ. Solitary papillary breast carcinoma metastasis to the large bowel presenting as primary colon carcinoma: case report and review of the literature. Am Surg. (2003) 69:799–803. doi: 10.1177/000313480306900914
56
MaekawaHFujikawaTTanakaA. Successful laparoscopic investigation and resection of solitary colonic metastasis from breast cancer (with video). BMJ Case Rep. (2012) 2012. doi: 10.1136/bcr-2012-007187
57
KoufopoulosNGoudeliCPigadiotiEBalalisDManatakisDKAntoniadouFet al. Synchronous colonic adenocarcinoma and metastatic lobular carcinoma in a colectomy specimen: A rare finding. Cureus. (2018) 10:e3207. doi: 10.7759/cureus.3207
58
CritchleyACHarveyJCarrMIwuchukwuO. Synchronous gastric and colonic metastases of invasive lobular breast carcinoma: case report and review of the literature. Ann R Coll Surg Engl. (2011) 93:e49–50. doi: 10.1308/147870811X582800
59
KachiANicolasGSemaanDBHashemMAbou SleimanC. Unusual pattern of invasive lobular carcinoma metastasis: A case report. Am J Case Rep. (2019) 20:1659–63. doi: 10.12659/AJCR.917237
60
Blachman-BraunRFelemoviciusIBarkerKKehrbergEKhanF. Widespread metastatic breast cancer to the bowel: an unexpected finding during colonoscopy. Oxf Med Case Rep. (2019) 2019:omy133. doi: 10.1093/omcr/omy133
61
JiaJHuangYLiX. Ascending colon metastasis after breast cancer surgery: a case report and literature review. Gland Surg. (2023) 12:309–16. doi: 10.21037/gs-22-642
62
ArifFZBreeseROBurkeR. Breast cancer metastasis to colon. Am Surg. (2023) 89:3873–4. doi: 10.1177/00031348231173979
Summary
Keywords
colon metastasis, progesterone receptor, estrogen receptor, non-specific types of breast cancer, breast cancer
Citation
Li H, Yang L, Sun X, Wang Z, Qin S, Li C, Liu G, Xie F and Gao W (2025) Changes in hormone receptor when breast cancer metastasizes to the colon: case report and literature review. Front. Oncol. 14:1391393. doi: 10.3389/fonc.2024.1391393
Received
22 April 2024
Accepted
27 December 2024
Published
29 January 2025
Volume
14 - 2024
Edited by
Daniel Reis Waisberg, Hospital das Clinicas da Faculdade de Medicina da USP (HC-FMUSP), Brazil
Reviewed by
Nektarios I. Koufopoulos, University General Hospital Attikon, Greece
Hanen Bouaziz, Salah Azaiez Institute, Tunisia
Updates
Copyright
© 2025 Li, Yang, Sun, Wang, Qin, Li, Liu, Xie and Gao.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Weiwei Gao, weiwei_gao2023@163.com; Fengming Xie, fengming_xie@163.com
†These authors have contributed equally to this work
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.