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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2005

01-11-2005 | Original Articles

Breast Cancer: Presentation and Intervention in Women With Gastrointestinal Metastasis and Carcinomatosis

Authors: Elisabeth C. McLemore, MD, Barbara A. Pockaj, MD, Carol Reynolds, MD, Richard J. Gray, MD, Jose L. Hernandez, BA, Clive S. Grant, MD, John H. Donohue, MD

Published in: Annals of Surgical Oncology | Issue 11/2005

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Abstract

Background

Breast cancer metastatic to the gastrointestinal tract or peritoneum is rare. We reviewed the natural history of ductal and lobular carcinoma in women with breast cancer metastatic to the gastrointestinal tract, peritoneum, or both.

Methods

We performed a retrospective review of all patients (1985–2000) with a pathologic diagnosis of breast cancer metastatic to the gastrointestinal tract or peritoneum. Patients were categorized into three groups: those with gastrointestinal metastasis, carcinomatosis, or both.

Results

Of 73 patients, 23 (32%) had gastrointestinal metastasis only, 32 (44%) had carcinomatosis only, and 18 (25%) had both. The median age at initial breast cancer diagnosis was 55 years. The mean interval between the primary diagnosis and metastatic presentation was 7 years. Sites of gastrointestinal metastases included the esophagus (8%), stomach (28%), small intestine (19%), and colon and rectum (45%). Infiltrating lobular carcinoma represented 34 (64%) of the 53 gastrointestinal metastases. The median overall survival after diagnosis was 28 months. Palliative surgical intervention in 47 patients (64%) did not affect overall survival. Some survival benefit may have accrued to select patients with gastrointestinal metastasis who underwent surgical palliation (44 vs. 9 months). Advanced age at diagnosis and gastric metastases had a negative effect on survival, whereas treatment with systemic chemotherapy or tamoxifen had a positive effect on survival.

Conclusions

Gastrointestinal metastasis occurred more often in patients with invasive lobular carcinoma. Surgical intervention did not significantly extend overall survival but may be considered in a select group of patients.
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Metadata
Title
Breast Cancer: Presentation and Intervention in Women With Gastrointestinal Metastasis and Carcinomatosis
Authors
Elisabeth C. McLemore, MD
Barbara A. Pockaj, MD
Carol Reynolds, MD
Richard J. Gray, MD
Jose L. Hernandez, BA
Clive S. Grant, MD
John H. Donohue, MD
Publication date
01-11-2005
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 11/2005
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2005.03.030

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