RESUMO
Although the lung, liver, or bones are the most common location for distant metastases in breast cancer patients, metastases to the intestinal tract are very rarely recognized in the clinic. We will present an unusual case of colonic metastasis from a carcinoma of the breast that mimics a primary intestinal cancer, along with a through review of English language medical literature. Despite the fact that isolated gastrointestinal (GI) metastases are very rare and much less common than benign disease processes or second primaries of the intestinal tract in patients with a history of breast cancer, metastatic disease should be given consideration whenever a patient experiences GI symptoms.
Assuntos
Humanos , Feminino , Adulto , Tomografia Computadorizada por Raios X/métodos , Segunda Neoplasia Primária/diagnóstico , Metástase Neoplásica , Neoplasias Intestinais/diagnóstico , Diagnóstico Diferencial , Neoplasias do Colo/diagnóstico , Carcinoma/diagnóstico , Neoplasias da Mama/diagnóstico , Mama/patologiaRESUMO
AIM: To evaluate the prognostic significance of HER-2/neu overexpression in hormone receptor and axillary lymph node positive breast cancer patients treated in a single institution. METHODS: Paraffin-embedded primary breast cancers from 40 patients with invasive ductal carcinoma were studied immunohistochemically. HER-2/neu staining was classified as negative (0, 1+), weak/moderate positive (2+), or moderate/strong positive (3+) and was assessed for effectiveness as a predictor of outcome in univariate and Cox model multivariate analyses. RESULTS: 20% of patients were positive for HER-2/neu. Significant associations were observed between HER-2/neu and increasing number of involved nodes (p = 0.014), p53 positivity (p = 0.039), the presence of vascular invasion (p = 0.029) and metastases (p = 0.01). Multivariate analysis demonstrated that HER-2/neu overexpression (p = 0.016) and age (p = 0.005) were independent predictors for disease-free survival (DFS) where the number of involved nodes (p = 0.032) was shown to be independent predictor for overall survival. In the HER-2/neu positively stained tumors, significant number of patients developed distant metastases than the patients with HER-2/neu negatively stained tumors (87.5% vs 34.4%, p = 0.01). CONCLUSION: For node positive patients, HER-2/neu overexpression was a significant predictor of DFS.