Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. May 24, 2021; 12(5): 382-392
Published online May 24, 2021. doi: 10.5306/wjco.v12.i5.382
Intestinal metastasis from breast cancer: Presentation, treatment and survival from a systematic literature review
Elena Bolzacchini, Olga Nigro, Davide Inversini, Monica Giordano, Giovanni Maconi
Elena Bolzacchini, Department of Oncology, Ospedale Sant' Anna, ASST Lariana, Como 22100, Italy, Department of Medicine and Surgery, University of Insubria, Varese 21100, Italy
Olga Nigro, Department of Oncology, Ospedale di Circolo ASST-Sette Laghi, Varese 21100, Italy
Davide Inversini, Department of General Surgery, Ospedale Sant' Antonio Abate, ASST Lariana, Cantu' 22100, Italy.
Monica Giordano, Department of Oncology, Ospedale Sant' Anna, ASST Lariana, Como 22100, Italy
Giovanni Maconi, Department of Biomedical and Clinical Sciences, Gastroenterology Unit, "Luigi Sacco" University Hospital, Milano 20157, Italy
Author contributions: All authors contributed to the study conception and design; material preparation, data collection and analysis were performed by Bolzacchini E, Nigro O, Inversini D and Maconi G; the first draft of the manuscript was written by Bolzacchini E and Maconi G; Giordano M revised it carefully; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Elena Bolzacchini, MD, Doctor, Department of Oncology, Ospedale Sant' Anna, ASST Lariana, Via Ravona 20, San Fermo della Battaglia, Como 22100, Italy. elena.bolzacchini@hotmail.it
Received: January 5, 2021
Peer-review started: January 5, 2021
First decision: January 18, 2021
Revised: January 23, 2021
Accepted: April 13, 2021
Article in press: April 13, 2021
Published online: May 24, 2021
Abstract
BACKGROUND

Intestinal metastases from breast cancer (BC) arerare; available data depend mainly on case reports and case series.

AIM

To conduct a review of the literature regarding presentation, diagnosis, treatment and survival of patients with intestinal metastasis from BC.

METHODS

We identified all articles that described patients with intestinal metastasis (from duodenum to anum) from BC using MEDLINE (1975 to 2020) and EMBASE (1975 to 2020) electronic databases.

RESULTS

We found 96 cases of intestinal metastasis of BC. Metastasization involved large bowel (cecum, colon, sigmoid, rectum) (51%), small bowel (duodenum, jejunum, ileum) (49%), and anum (< 1%). Median age of patients was 61-years. The most frequent histology was infiltrating lobular carcinoma followed by infiltrating ductal carcinoma. In more than half of patients, the diagnosis was made after the diagnosis of BC (median: 7.2 years) and in many cases of emergency, for bowel obstruction, bleeding or perforation. Diagnosis was achieved through endoscopy, radiological examination or both. In most of the cases, patients underwent surgery with or without systemic therapies. Survival of patients included in this review was available in less than 50% of patients and showed an overall median of 12 mo since diagnosis of the intestinal metastasis.

CONCLUSION

Although, intestinal metastases of BC are considered a rare condition, clinicians should consider the possibility of intestinal involvement in case of abdominal symptoms even in acute setting and many years after the diagnosis of BC, especially in patients with a histology of lobular carcinoma.

Keywords: Breast cancer, Intestinal metastasis, Diagnosis, Treatment, Small bowel, Large bowel

Core Tip: We conducted a review of the literature regarding presentation, diagnosis, treatment and survival of patients with intestinal metastasis from breast cancer (BC). Although intestinal metastases of BC are considered a rare condition, several cases are reported from the available literature. Clinicians should consider the possibility of intestinal involvement in case of abdominal symptoms even in acute setting and many years after the diagnosis of BC.