Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Colorectal cancer metastatic to the breast: A case report
Silvia Taccogna, Elisa Gozzi, Luigi Rossi, Davide Caruso, Davide Conte, Patrizia Trenta, Valentina Leoni, Silverio Tomao, Lucrezia Raimondi, Francesco Angelini
Silvia Taccogna, Department of Pathology, Regina Apostolorum, Albano 00041, Rome, Italy
Elisa Gozzi, Luigi Rossi, Lucrezia Raimondi, UOC of Oncology, Sapienza University of Rome, Aprilia 04011, Rome, Italy
Davide Caruso, Davide Conte, Patrizia Trenta, Valentina Leoni, Francesco Angelini, Medical Oncology Unit, Regina Apostolorum Hospital, Albano 00041, Rome, Italy
Silverio Tomao, Division of Medical Oncology A, Sapienza University of Rome, Albano 00161, Rome, Italy
Author contributions: Taccogna S was the primary editor and conceived the idea for manuscript; Gozzi E wrote the manuscript; Rossi L and Angelini F reviewed the literature; Leoni V, Caruso D and Conte D reviewed the manuscript according to the authors’ instructions; Trenta P and Raimondi L made English language revisions; Tomao S coordinated the realization of the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the guidelines from the checklist have been adopted in the preparation of this manuscript.
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: Luigi Rossi, MD, Doctor, UOC of Oncology, Sapienza University of Rome, viale giustiano snc, Aprilia 04011, Rome, Italy. dr.rossi@ymail.com
Received: April 24, 2020
Peer-review started: April 24, 2020
First decision: July 4, 2020
Revised: April 24, 2020
Accepted: August 16, 2020
Article in press: August 16, 2020
Published online: September 15, 2020
BACKGROUND
Breast metastases from colorectal cancer (CRC) are very uncommon. There is no unanimous consensus regarding the best treatment for this rare condition, and management is, especially in elderly patients, limited to diagnosis and palliative care. Capecitabine, an oral fluoropyrimidine derivative, might be helpful in controlling the disease and may be a treatment option for patients unable to receive more aggressive chemotherapy.
CASE SUMMARY
We report a case of synchronous massive breast metastasis from CRC in an 85 year old patient who came to the hospital presenting a huge mass originating from the axillary extension of the right breast. A whole body computed tomography also showed a mass in the right colon. The patient underwent a simple right mastectomy along with right hemicolectomy. The resected breast showed massive metastasis from CRC with intense and homogeneous nuclear CDX2 staining, while the colon specimen revealed poorly differentiated adenocarcinoma stage pT4a pN0 pM1 (breast) (Tumor Node Metastasis 2017). Three months later she developed a subcutaneous mass at the site of the previous mastectomy. An ultrasound guided biopsy was carried out again and revealed a metastasis from CRC. The patient then started treatment with capecitabine plus bevacizumab, obtaining stable disease (RECIST criteria) and a clinical benefit after 3 mo of therapy.
CONCLUSION
In our experience, capecitabine and bevacizumab may be a useful treatment option for breast metastases from primary CRC in elderly patients.
Core Tip: Colorectal cancer (CRC) metastases to the breast is a rare occurrence, and patients with breast metastases from CRC generally have a poor prognosis. Early recognition and full characterization of the disease and patient can potentially optimize the treatment plan. Capecitabine and bevacizumab combination may provide a useful option for breast metastases from primary CRC in elderly patients.
