Abstract Breast cancer metastasis to the gastrointestinal tract represents an important cause of mortality associated with this neoplasm. Its diagnosis is challenging due to the nonspecific nature of the clinical symptoms and the time interval that usually elapses between the primary disease and recurrence. We herein report a case of colonic metastasis secondary to breast carcinoma. A 68-year-old woman with a history of right-breast invasive ductal carcinoma, clinical stage IIIA (grade T2N2M0 in the Tumor, Node, Metastasis TNM classification), triple-negative, had been treated in 2015 with mastectomy and axillary lymph-node dissection, followed by adjuvant chemotherapy and radiotherapy. In 2020, recurrence of the disease was documented in the right supraclavicular and axillary lymph nodes, managed with multiple cytotoxic regimens and local radiotherapy. During the tenth year of follow-up, an abdominal computed tomography (CT) scan was performed due to changes in stool consistency, which revealed thickening of the cecum and ascending colon. Colonoscopy showed a stenosing lesion at the ileocecal valve, impassable with the endoscope. Staging studies revealed no other secondary lesions. Given the imminent risk of intestinal obstruction, a laparoscopic right hemicolectomy with complete mesocolic excision was performed. The immunohistochemical analysis confirmed high-grade triple-negative breast metastasis (Ki-67 of 80%, extensive lymphovascular invasion, 12/31 positive nodes). The postoperative evolution was favorable, with hospital discharge on the fourth day. In patients with suspected breast cancer recurrence, restaging studies are mandatory to rule out oncologic involvement in different organs. The gold standard for diagnosis is based on biopsy of the suspicious lesion, along with basic staining and immunohistochemical markers, which enable the confirmation of the origin of the neoplastic involvement and its tumor biology. Maintaining a high index of diagnostic suspicion is essential for early detection and the establishment of appropriate treatment, contributing to improved patient prognosis.
Riscanevo-Bobadilla et al. (Thu,) studied this question.