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1

Markovic, Marina, Dalibor Jovanovic, Zeljko Todorovic, et al. "Primary Small Cell Carcinoma Of Lung With Metachronous Breast Metastasis." Serbian Journal of Experimental and Clinical Research 18, no. 3 (2017): 263–67. http://dx.doi.org/10.1515/sjecr-2016-0087.

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Abstract Breast metastases from an extra-mammary malignancy are rare. Among the lung malignancies that metastasise in the breasts, previous literature has described approximately 30 cases of NSCLC and only a few cases of SCLC. Here, we present a 54-year-old woman with metachronous breast metastasis from pulmonary small cell carcinoma. She presented with a soft tissue mass in the right lung hilum. After bronchoscopy with biopsy, SCLC was verified. Th e patient was given 4 cycles of etoposide and cisplatin followed by radiation therapy. Seven months after the diagnosis of primary lung cancer, the patient palpated a mass in her right breast. Clinical examination and further diagnostics revealed the suspected malignancy, and a radical mastectomy was performed. Immunohistochemical findings suggested metastatic SCLC in the breast. Differentiation between primary and metastatic cancer in the breast is very important for therapeutic planning
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2

Saad Abdalla Al-Zawi, Abdalla, Andrzej Ratajczak, Philip Idaewor, et al. "Primary lung cancer with metastasis to the ipsilateral breast-a case report." International Journal of Research in Medical Sciences 6, no. 1 (2017): 334. http://dx.doi.org/10.18203/2320-6012.ijrms20175744.

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The metastasis of extra-mammary malignancy to breast is extremely rare; literature reports the incidence between 0.4-1.3%. Primary sites include the contralateral breast, leukaemia, lymphoma, malignant melanoma, sarcoma, lung, prostate, ovary, colon and the stomach. Here we present a rare case in which lung cancer was found to metastasise to the breast. Initially the patient presented with chest symptoms and a left breast lump was detected clinically. The radiological and histological investigations confirmed the diagnosis of primary lung cancer with breast metastases. Prognosis of such cases is generally poor.
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3

Costa, Weruska Alcoforado, José Eleutério Jr., Paulo César Giraldo, and Ana Katherine Gonçalves. "Quality of life in breast cancer survivors." Revista da Associação Médica Brasileira 63, no. 7 (2017): 583–89. http://dx.doi.org/10.1590/1806-9282.63.07.583.

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Summary Objective: To evaluate the influence of functional capacity (FC) and how it affects quality of life (QoL) in breast cancer survivors. Method: A total of 400 breast cancer survivors were studied - 118 without metastasis, 160 with locoregional metastasis and 122 with distant metastasis. The European Organization for Research and Treatment for Cancer Quality of Life Questionnaire--Core 30 (EORTC QLQ-C30), Breast Cancer-Specific (EORTC QLQ-BR23), and the Karnofsky Performance Scale (KPS) were used to evaluate FC and QoL. Results: Women with distant metastases presented lower KPS 75.3 (SD=12.5) (p<0.001). For QLQ-C30, the mean of the Functional Scale for patients with distant metastasis was 57 (SD=19) (p<0.001), and the mean of the Symptom Scale for patients with distant metastasis was 37 (SD=20) (p<0.001). Both the scales for pain and fatigue showed the highest mean in the groups. For the Global Health Scale, patients without metastasis scored a mean of 62 (SD=24) points, while those with locoregional metastases scored a mean of 63 (SD=21.4), and distant metastasis scored 51.3 (SD=24) points. In the group with distant metastases, 105 (87%) had pain, and the average KPS was 74 (SD=12.0) (p=0.001). Conclusion: Breast cancer was associated with decreased FC, compromised QoL in women with locoregional and distant metastases compared to those without metastasis.
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4

Kayılıoğlu, Selami Ilgaz, Cihangir Akyol, Ebru Esen, et al. "Gastric Metastasis of Ectopic Breast Cancer Mimicking Axillary Metastasis of Primary Gastric Cancer." Case Reports in Gastrointestinal Medicine 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/232165.

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Ectopic breast tissue has the ability to undergo all the pathological changes of the normal breast, including breast cancer. Gastrointestinal metastasis of breast cancer is rarely observed and it is very difficult to differentiate gastric metastases from primary gastric cancer. We present a case of 52-year-old female, who suffered from abdominal pain. Physical examination showed a palpable mass in the left anterior axilla and computerized tomography revealed gastric wall thickening with linitis plastica. When gastroscopic biopsy showed no signs of malignancy, excisional biopsy was performed in the left axilla. Histological examination revealed invasive lobular carcinoma of the breast, consistent with ectopic breast cancer. Further gastroscopic submucosal biopsies and immunohistochemical studies revealed gastric metastases of invasive lobular carcinoma. Axillary ectopic breast tissue carcinomas can mimic axillary lymphadenopathies. Additionally, gastric metastasis of breast cancer is an uncommon but possible condition. To the best of our knowledge, this is the first report of ectopic breast cancer with gastric metastasis.
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5

Zhang, Luyan, Xifa Wu, Yong Feng, Linlin Zheng, and Jinbo Jian. "Selenium donors inhibits osteoclastogenesis through inhibiting IL-6 and plays a pivotal role in bone metastasis from breast cancer." Toxicology Research 9, no. 4 (2020): 544–51. http://dx.doi.org/10.1093/toxres/tfaa053.

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Abstract Bone metastases are a frequent complication of breast cancer, and there has been little progress in the treatment of breast cancer patients with bone metastases. The cytotoxicity of selenium donors, including organic selenium and selenium nanoparticles (SeNPs), to cancer cells has been reported previously, but their relationship with bone metastases progression is not fully clear yet. In this study, multicenter clinical exploration was conducted to obtain dietary selenium intakes of breast cancer patients with or without bone metastasis, to study the relationship between selenium and breast cancer prognosis and bone metastasis. We found that dietary selenium intakes were significantly lower in breast cancer patients with bone metastasis, comparing with the non-bone metastasis cases. Selenium lower group of bone metastasis breast cancer patients had worse prognosis, whereas the daily selenium intakes could not predict the prognosis of breast cancer patients without bone metastasis. Subsequently, we study the regulatory role of selenium donors on bone metastasis at the cellular level, by challenging the cells with SeNPs. SeNPs showed potent cytotoxicity in breast cancer cells, no matter whether they were primary or bone-metastatic. SeNPs treated cancer cell inhibited the survival and differentiation of osteoclast progenitor cells. At the molecular level, we demonstrated that IL-6 partially mediated osteoclastogenesis suppression by SeNPs. These results provide a new way for biomarkers or drug development to treat and even prevent bone metastases of breast cancer by using selenium donors.
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6

Cebeci, Dua, Sirin Yaşar, and Pembegul Güneş. "Periocular Metastasis From Breast Carcinoma:A Case Report." International Journal of Medical Reviews and Case Reports 4, Reports in Neurology, Neurosur (2020): 1. http://dx.doi.org/10.5455/ijmrcr.periocular-metastasis-from-breast-carcinoma.

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7

Yazdani, Akram, Sara Dorri, Alireza Atashi, Hoda Shirafkan, and Hedieh Zabolinezhad. "Bone Metastasis Prognostic Factors in Breast Cancer." Breast Cancer: Basic and Clinical Research 13 (January 2019): 117822341983097. http://dx.doi.org/10.1177/1178223419830978.

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Objective: Bone is the most common site of metastasis in breast cancer. Prognostic factors for predicting bone metastases in breast cancer are controversial yet. In this study, we investigated clinical factors associated with secondary bone metastasis of breast cancer. Methods: In total, 1690 patients with breast cancer recorded between 2002 and 2012 in Motamed Cancer Institute, Tehran, Iran entered in the retrospective study. We studied age, menopausal status, histologic type, tumor size, number of cancerous axillary lymph nodes, serum concentrations of alkaline phosphatase (ALP), carcinogenicity antigen (CEA), cancer antigen (CA)-153, and hemoglobin (HB) in 2 groups with bone metastases (n = 123) and without it, respectively. We applied logistic regression to identify bone metastasis prognostic factors in breast cancer patients and calculated the cut-off value, sensitivity, and characteristics of independent prognostic factors using receiver operating characteristic (ROC) curve analysis. Results: Menopause, larger tumor size, and the greater number of cancerous axillary lymph nodes increased the chance of bone metastases significantly ( P < .05). There was no significant difference between mean groups with and without bone metastases regarding serum concentration of CEA, CA-153, HB, and histopathologic type ( P > .05). Logistic regression showed that age (odds ratio (OR) = 1.021), menopausal status (OR = 1.854), number of cancerous axillary lymph nodes (OR = 1.065), a tumor size between 2 and 5 cm diameter (OR = 2.002) and more than 5 cm diameter (OR = 4.009), and ALP (OR = 1.005) are independent prognostic factors associated with bone metastases. The ROC curve showed that the abovementioned factors have comparable predictive accuracy for bone metastases. Conclusions: Age, menopausal status, number of axillary lymph node metastases, tumor size, and ALP were identified as prognostic factors for bone metastasis in patients with breast cancer. So patients with these characteristics should be monitored more precisely with regular follow-ups.
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8

Al-Muqbel, Kusai M. "Bone Marrow Metastasis Is an Early Stage of Bone Metastasis in Breast Cancer Detected Clinically by F18-FDG-PET/CT Imaging." BioMed Research International 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/9852632.

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Objective. To determine the value of 18F-FDG PET/CT in detection of bone marrow (BM) metastasis in breast cancer which is considered an early stage of bone metastasis. Patients and Methods. Retrospectively, breast cancer patients with bone metastasis were included. BM metastasis was considered if the lesion was PET positive/CT occult while bone metastasis was considered if the lesion was PET positive/ CT positive. BM metastases were observed sequentially on F18-FDG PET/CT. Results. We included 35 patients. Eighteen patients (51%) had BM metastases in addition to other bone metastases. BM metastases comprised 24% of all lesions. Posttreatment scan was performed on 26/35 patients. Twenty-three percent of BM metastases had resolved completely without causing bone destruction after treatment. Sixty-five percent of BM metastases had converted into bone metastases after treatment. Twelve percent of BM metastases had persisted after treatment. Conclusion. This retrospective study showed clinically by 18F-FDG PET/CT imaging that BM metastasis is an early stage of bone metastasis in breast cancer. Interestingly, 18F-FDG-PET/CT showed that early eradication of individual BM metastasis by systemic treatment precluded development of bone metastasis. However, more research is needed to study the impact of an early diagnosis of BM metastases on treatment outcome.
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9

Müller, Volkmar, Elena Laakmann, Astrid Grottke, Kerstin Riecke, and Isabell Witzel. "Cerebral metastasis in breast cancer." Senologie - Zeitschrift für Mammadiagnostik und -therapie 15, no. 04 (2018): 213–18. http://dx.doi.org/10.1055/a-0753-3504.

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AbstractThe incidence of breast cancer brain metastases has risen steadily in recent years. Brain metastases are often the limiting factor of the disease, as survival is usually only a few months after brain metastasis occurs. Apart from the poor prognosis, cognitive and neurological deficits lead to a massive impairment of quality of life. HER2-positive or triple-negative cancers develop brain metastases more often. Studies on the subject of brain metastases were conducted mainly in cohorts with different primary tumours. To improve the available data on patients with breast cancer, the “Brain Metastases in Breast Cancer (BMBC)” registry was initiated to record the German care reality. Because of the lack of specific systemic treatment options, the main primary therapy of brain metastases is local (surgery, stereotactic radiation, whole-brain radiation). Local therapy is supplemented by systemic therapy. The choice of systemic therapy is guided especially by the extracranial disease situation, as there are practically no study data currently on the subject of systemic therapy of brain metastases specifically. Only very recently have drugs been investigated explicitly in women with breast cancer brain metastases.
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10

Mandaliya, Hiren, Joshua Sung, Joanna Hill, Ramin Samali, and Mathew George. "Prostate Cancer: Cases of Rare Presentation and Rare Metastasis." Case Reports in Oncology 8, no. 3 (2015): 526–29. http://dx.doi.org/10.1159/000442045.

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Prostate cancer is the second most common cancer in men. Diagnosis of early disease is based on prostate biopsy which is carried out because of symptoms of prostatism or asymptomatic rise in PSA. On the other side, advanced disease can locally invade and metastasise to lymph nodes, bones, lungs, etc. Initial presentation of prostate cancer in form of brain metastasis is extremely seldom. Similarly, prostate cancer, which metastasised to the breast, is very rare too. Here, we discuss two unique cases of prostate cancer, one of them had an initial presentation of brain metastasis from prostate adenocarcinoma and the other case had an established diagnosis of prostate cancer metastasised to the breast. In theory, cancer can cause metastatic spread to any part of the body; however diversity into such presentation or progression from prostate cancer has not been frequently noticed.
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11

Dong, Qian, Mi Zhang, and Da Jiang. "Relationship between tumor size and metastatic site in patients with stage IV breast cancer: A large SEER-based study." Journal of Clinical Oncology 39, no. 15_suppl (2021): e13065-e13065. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e13065.

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e13065 Background: To analyze the correlation between tumor size and metastatic site in first-diagnosed stage IV breast cancer patients. Methods: Stage IV breast cancer patients diagnosed from 2010 to 2015 were screened by the Surveillance, Epidemiology, and End Results (SEER) database. The characteristics of clinical variables were represented by a frequency table, and the Chi-square test was used for comparison. At the same time, the Chi-square test was used to analyze the relationship between tumor size and organ metastasis. Correlation between tumor size and the prognosis of patients was contributed by KM curve and Log-rank test. Results: Regardless of tumor size, the proportion of bone metastasis was higher and brain metastasis was lower in breast cancer patients. There were significant differences in the site of metastases based on different subtype. Luminal A and Luminal B breast cancer had the highest proportion of bone metastases; brain metastasis accounted for the highest proportion in triple-negative breast cancer (TNBC); while the incidence of liver metastasis was the highest in Her-2(+) breast cancer. At the same time, the results indicated that Luminal A breast cancer with a tumor size > 5 cm was more likely to develop multi-site metastasis and lung metastasis, while Luminal B breast cancer with a tumor size ≤ 5 cm was more likely to develop liver metastasis. The results also revealed that TNBC patients with a tumor size of 0 - 2cm were more likely to develop bone metastasis than those with a tumor size > 5 cm, and the incidence of lung metastasis in triple-negative patients showed an increasing trend with the increase of tumor size. Conclusions: Based on subtype, we found that there was a significant difference between tumor size and metastatic site in patients with stage IV breast cancer, and the difference was statistically significant. This study provided evidence-based basis for decision-making of stage IV breast cancer treatment.
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12

Begum, Shamim MF, Fatima Begum, Pupree Mutsuddy, Layla S. Banu, and Raihan Hussain. "Superficial Metastases from Breast Cancer and Gallbladder: Detected by 18F FDG PET-CT Scan." Bangladesh Journal of Nuclear Medicine 20, no. 1 (2018): 56. http://dx.doi.org/10.3329/bjnm.v20i1.36862.

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<p>Cutaneous and subcutaneous metastases from internal malignancies are rare. The reported incidence of subcutaneous metastasis is 5.3% and cutaneous metastasis account for 0.7% and 9% of all metastases. Here we reported two cases of cutaneous metastasis, one from gall bladder cancer and other from breast cancer. Among all internal malignancies the incidence of cutaneous metastasis in breast cancer is highest whereas in gall bladder cancer is rare. Detection of cutaneous or subcutaneous metastasis determines the staging, prognosis and management strategy of the disease. 18F FDG PET- CT (18 Fluorine fluorodeoxyglucose positron emission tomography computerized tomography) scan has been reported to play a potential role in the identification of cutaneous or subcutaneas metastasis. These metastases were detected on whole body 18F FDG PET-CT scan during restaging of the disease. The lesions were FDG avid and biopsy proven metastasis. Intense FDG avidity with SUV max 10.5 was revealed in nodular lesion in abdominal wall from gall bladder cancer. The nodular lesion in gluteal region in a patient with breast cancer had low avidity with SUV max 3.8 later evaluated as cutaneous metastasis. Here the cases are reported to emphasize the PET-CT imaging as a potentially used one-stop-shop imaging modality in patients with cutaneous or subcutaneous metastases from internal malignancies. PET-CT imaging can reliably identify hypermetabolic cutaneous metastasis and can help not only to restage the disease but also to guide new therapeutic strategies.</p><p>Bangladesh J. Nuclear Med. 20(1): 56-58, January 2017</p>
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13

Svensson, Elisabeth, Christian F. Christiansen, Sinna P. Ulrichsen, Mikael R. Rørth, and Henrik T. Sørensen. "Survival after bone metastasis by primary cancer type: a Danish population-based cohort study." BMJ Open 7, no. 9 (2017): e016022. http://dx.doi.org/10.1136/bmjopen-2017-016022.

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ObjectiveIn the 10 most common primary types with bone metastases, we aimed to examine survival, further stratifying on bone metastases only or with additional synchronous metastases.MethodsWe included all patients aged 18 years and older with incident hospital diagnosis of solid cancer between 1994 and 2010, subsequently diagnosed with BM until 2012. We followed patients from date of bone metastasis diagnosis until death, emigration or 31 December 2012, whichever came first. We computed 1-year, 3-year and 5-year survival (%) and the corresponding 95% CIs stratified on primary cancer type. Comparing patients with bone metastasis only and patients with other synchronous metastases, we estimated crude and adjusted HRs and corresponding 95% CI for mortality.ResultsWe included 17 251 patients with bone metastasis. The most common primary cancer types with bone metastasis were prostate (34%), breast (22%) and lung (20%). One-year survival after bone metastasis diagnosis was lowest in patients with lung cancer (10%, 95% CI 9% to 11%) and highest in patients with breast cancer (51%, 50% to 53%). At 5 years of follow-up, only patients with breast cancer had over 10% survival (13%, 11% to 14%). The risk of mortality was increased for the majority of cancer types among patients with bone and synchronous metastases compared with bone only (adjusted relative risk 1.29–1.57), except for cervix, ovarian and bladder cancer.ConclusionsWhile patients with bone metastases after most primary cancers have poor survival, one of ten patients with bone metastasis from breast cancer survived 5 years.
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14

Kitahara, Miyuki, Yasuo Hozumi, Rio Asada, Aya Sawa, Hitoaki Saito, and Tatsuo Iijima. "Intramammary Metastasis in a Patient with a History of Renal Cell Carcinoma: A Case Report." Case Reports in Oncology 11, no. 2 (2018): 318–22. http://dx.doi.org/10.1159/000489391.

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Intramammary metastasis of renal cell carcinoma (RCC) is extremely rare, accounting for only 1.5% of all intramammary metastases. Distinguishing intramammary metastases from benign tumors and breast cancer is clinically problematic. Some patients undergo excessive surgery after a misdiagnosis of breast cancer instead of a mammary tumor. We performed a core needle biopsy (CNB) of a breast mass that developed in a 71-year-old woman after surgeries for bilateral RCC and breast cancer, leading to a diagnosis of intramammary metastasis of RCC. In this case, the CNB and immunohistochemical examination were critical for reaching a definitive diagnosis. We conclude that, when examining patients with mammary tumors, establishing their history of malignant tumors may help diagnose intramammary metastasis and select the best treatment strategy.
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15

Tsung, Swei H. "Metastasis of Colon Cancer to the Breast." Case Reports in Oncology 10, no. 1 (2017): 77–80. http://dx.doi.org/10.1159/000455225.

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Breast metastases from extramammary neoplasms are extremely rare, and even more so is metastasis of colon cancer to the breast. Despite its rarity, metastatic disease to the breast is an important diagnostic issue because its treatment differs greatly from that of primary cancer. Proper diagnosis of this rare event requires an accurate clinical history, proper immunohistochemical workup, and a high level of suspicion.
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16

Shi, Dongning, Junwen Bai, Yibo Chen, Xia Wang, Yafeng Zhang, and Hong Liu. "Predicting the Incidence and Prognosis of Bone Metastatic Breast Cancer: A SEER-Based Observational Study." BioMed Research International 2020 (November 25, 2020): 1–9. http://dx.doi.org/10.1155/2020/1068202.

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Background. To determinate the association relationship of breast cancer bone metastasis and cancer characteristics and molecular subtype. Furthermore, to evaluate the impact of molecular subtype on prevalence and prognosis of bone metastasis from the breast cancer base on a large population real-word program, the Surveillance, Epidemiology, and End Results (SEER) database. Methods. We collected and analyzed the data obtained from SEER, which showed molecular subtype information for each patient. The prevalence and outcome of bone metastasis in breast cancer were estimated as per the different molecular subtypes. Results. Occurrence of bone metastasis in conformity with four different molecular subtypes in all 42684 breast cancer patients was 6.2, 9.4, 7.9, and 6.4%, respectively. The most unfavorable subtype was the triple-negative breast cancer (TNBC), followed by the luminal A, luminal B, and HER2 subtypes (hazard ratio [HR] of luminal A compared with TNBC, 0.533, 95% confidence interval, 0.444–0.641; HR of luminal B, 0.482, 95% CI 0.419–0.555; HR of HER2 subtype, 0.542, 95% CI 0.484–0.608). Brain metastasis impacts overall survival (OS) ( p < 0.001 ) fundamentally, and visceral metastases also significantly decreased OS ( p < 0.001 ). Conclusion. Bone metastasis patients present a more favorable oncological survival consequence than other metastases, and the TNBC subtype with bone metastasis showed the poorest tumor outcome compared with the other three molecular subtypes.
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17

Medeiros, Braeden, and Alison L. Allan. "Molecular Mechanisms of Breast Cancer Metastasis to the Lung: Clinical and Experimental Perspectives." International Journal of Molecular Sciences 20, no. 9 (2019): 2272. http://dx.doi.org/10.3390/ijms20092272.

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Breast cancer is the most commonly diagnosed cancer in women worldwide, and >90% of breast cancer-related deaths are associated with metastasis. Breast cancer spreads preferentially to the lung, brain, bone and liver; termed organ tropism. Current treatment methods for metastatic breast cancer have been ineffective, compounded by the lack of early prognostic/predictive methods to determine which organs are most susceptible to developing metastases. A better understanding of the mechanisms that drive breast cancer metastasis is crucial for identifying novel biomarkers and therapeutic targets. Lung metastasis is of particular concern as it is associated with significant patient morbidity and a mortality rate of 60–70%. This review highlights the current understanding of breast cancer metastasis to the lung, including discussion of potential new treatment approaches for development.
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18

Haffty, B. G., M. Reiss, M. Beinfield, D. Fischer, B. Ward, and C. McKhann. "Ipsilateral breast tumor recurrence as a predictor of distant disease: implications for systemic therapy at the time of local relapse." Journal of Clinical Oncology 14, no. 1 (1996): 52–57. http://dx.doi.org/10.1200/jco.1996.14.1.52.

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PURPOSE To evaluate the prognostic significance of ipsilateral breast tumor recurrence (IBTR) with respect to the subsequent development of distant metastasis. MATERIALS AND METHODS Between January 1970 and December 1989, 973 patients with invasive breast cancer were treated with conservative surgery and radiation therapy at Yale-New Haven Hospital. The median follow-up time as of December 1993 was 8.6 years. A number of prognostic factors were tested as possible predictors of distant metastases, including whether a patient experienced IBTR. IBTRs were broken down by time to recurrence to determine whether the breast recurrence-free interval had any prognostic relevance with respect to the development of distant metastasis. RESULTS As of December 1993, out of the entire population of 973 patients, 73 patients had developed IBTR and 134 had developed distant metastases. The overall actuarial survival rate at 10 years was .71 +/- .02, with a 10-year actuarial breast recurrence-free rate of .84 +/- .02 and a 10-year distant metastasis-free rate of .77 +/- .02. The overall distant metastasis rate was higher in patients who experienced IBTR compared with patients who had never experienced IBTR. Furthermore, the time to IBTR had a significant effect on distant metastases. Of 32 patients who developed an IBTR within 4 years of original diagnosis, 16 (50%) developed distant metastases. In contrast, of 41 patients who developed later breast relapses (> 4 years from original diagnosis), only seven (17%) developed distant metastases (P < .01). Of 32 patients who developed early breast relapse, the 5-year survival rate following breast relapse was .50 +/- .01, compared with a 5-year post-breast relapse survival rate of .78 +/- .10 among 41 patients with later breast relapses (P < .05). CONCLUSION It appears that early IBTR is a significant predictor for distant metastases. Whether early breast tumor relapse is a marker for or cause of distant metastases remains a controversial and unresolved issue. Implications for adjuvant systemic therapy at the time of breast relapse are discussed.
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Buka, David, Josef Dvořák, Igor Richter, Nikolov Dimitar Hadzi, and Jiří Cyrany. "Gastric and Colorectal Metastases of Lobular Breast Carcinoma: A Case Report." Acta Medica (Hradec Kralove, Czech Republic) 59, no. 1 (2016): 18–21. http://dx.doi.org/10.14712/18059694.2016.50.

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Background: Occurrence of gastric metastasis as the first symptom of breast carcinoma with a long period of latency before presentation of the primary breast carcinoma is rare. Case Report: A patient with gastric metastasis as the first symptom of lobular breast carcinoma, treated by neoadjuvant preoperative chemoradiotherapy and total gastrectomy, with complete local control. Fourteen months after presentation of the gastric metastasis a primary lobular breast carcinoma was discovered, treated by radiotherapy, chemotherapy and hormonal treatment with complete local response. Twenty-three months after diagnosis of breast cancer multiple colorectal metastases from the breast cancer occurred, which were treated by chemotherapy and hormonal treatment. Eighty-six months after diagnosis of gastric metastasis the patient died due to progression of cancer. Conclusions: Metastases to gastrointestinal or gynaecological tracts are more likely in invasive lobular carcinoma than invasive ductal cancer. The pathologist should determine whether or not they check estrogen and progesterone receptor status not simply by signet ring cell morphology but also by consideration of clinic-pathological correlation of the patient, such as the presence of a past history of breast cancer, or the colorectal localization of poorly differentiated carcinoma, which may occur less frequently than in the stomach.
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Schem, C., A. M. Stark, H. M. Mehdorn, W. Jonat, and N. Maass. "Expression of metastasis suppressor gene maspin in breast cancer brain metastases." Journal of Clinical Oncology 24, no. 18_suppl (2006): 20057. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.20057.

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20057 Background: Recently our demonstrated that the expression of several Metastasis Suppressor Genes (MSG) is reduced in breast cancer brain metastases. Current data suggest that MSG Maspin (serpin B5) is a promising candidate for further treatment options. So, we examined the mRNA and protein expression of Maspin in normal breast tissue, breast cancer primaries, -brain metastases and breast cancer cell lines. Methods: Maspin mRNA expression was examined by real time reverse transcription polymerase chain reaction (RT-PCR) in fresh frozen samples from normal breast tissue, breast cancer primaries and -brain metastases. Furthermore maspin was examined in poorly invasive and non-metastatic breast cancer cell lines MCF-7, T47-D, in highly invasive and metastatic MDA-MB-231 breast cancer cells (231-parental) and in brain- and bone-selective metastatic clones (231-brain, 231-bone). Maspin protein was detected by immunohistochemistry in paraffin-embedded sections from 16 patients with breast cancer primaries and brain metastases using a specific monoclonal mouse antibody. Results: In relation to normal breast tissue, maspin mRNA expression was decreased in primary tumors and again decreased in brain metastases. Normalized ΔCT values were 1 (normal tissue), 0.3 (primary tumors) and 0.13 (brain metastases). Immunohistochemistry revealed the same tendency. 3 of 16 (19%) breast cancer primaries were positive whereas none of the brain metastases showed positive maspin staining. In comparison to poorly invasive breast cancer cell lines, maspin mRNA expression was decreased in 231-parental, increased in 231-brain and not detectable in 231-bone. Conclusions: Maspin expression is reduced in breast cancer brain metastases. It is differentially expressed in brain- and bone-selective metastatic cell lines. These results suggest an important role for maspin in breast cancer brain metastasis. No significant financial relationships to disclose.
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Özer, Özge, Emirhan Nemutlu, Cemil Can Eylem, et al. "Detection of brain metastasis by metabolomics methods in metastatic breast cancer patients." Journal of Clinical Oncology 37, no. 15_suppl (2019): e12572-e12572. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e12572.

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e12572 Background: The aim of this study was to identify markers for the early diagnosis of brain metastasis by metabolomic methods in breast cancer patients. Methods: A total of 88 breast cancer patients with distant metastases were included the study. The patients were divided into two groups according to their metastasis status as patients with brain metastases and patients with distant metastases without any brain metastases. For metabolomic analyses, liquid chromatography quadrupole time-of-flight mass spectrometry (LC-qTOF-MS) and gas chromatography mass spectrometry (GC-MS) analysis methods were used. Results: 88 patients were included the study. 33 of the 88 patients had brain metastasis group and 55 patients had distant metastases without brain metastasis. A total of 79 metabolites were identified by the GC-MS analysis. Of these, 11 of them (alanine, sphingosine, fructose, fumaric acid, glycine, lactic acid, phenylalanine, pyroglutamic acid, serine, threonine, and valine) were found at statistically significantly higher levels in the patient group with brain metastases (p < 0.05). In LC-qTOF-MS analysis 47 metabolites were identified with statistically significant results between the two groups. Predictive accuriecies for idendification of the brain metastasis with 5 and 10 metobolites models were 94.6% and 95.2%, respectively.Amino acyl tRNA biosynthesis, arginine and proline metabolism, nitrogen metabolism, cyanaminoacid metabolism, nicontic and nicotinicamide metabolism, glycine, serine and threonine metabolism pathways have been involved more significantly in patients with brain metastasis (p < 0.05). Conclusions: Although these results need to be confirmatory prospective studies, these data promising for early detection of the brain metastasis by markers in sera.
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Hague, Andrew. "Metastasis Breast Cancer." American Journal of Biomedical Science & Research 1, no. 6 (2019): 254. http://dx.doi.org/10.34297/ajbsr.2019.01.000559.

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23

Marino, Natascia, Stephan Woditschka, L. Tiffany Reed, et al. "Breast Cancer Metastasis." American Journal of Pathology 183, no. 4 (2013): 1084–95. http://dx.doi.org/10.1016/j.ajpath.2013.06.012.

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Hodgdon, Christine, and Laurie Campbell. "OTHR-09. Accelerating Research for Breast Cancer Brain Metastasis and Leptomeningeal Disease through Patient-led Collaborations." Neuro-Oncology Advances 3, Supplement_3 (2021): iii16. http://dx.doi.org/10.1093/noajnl/vdab071.064.

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Abstract Patient-driven Initiative of the Metastatic Breast Cancer (MBC) Alliance The Breast Cancer Brain Metastasis (BCBM) Initiative: Marina Kaplan Project launched in June 2020 as an official project of the MBC Alliance which includes 32 nonprofits, 12 industry partners, and 30 individual patient advocates. The Marina Project has grown to include 35members with representation from industry, research institutions, and individual patients. Nearly one-third of the group is comprised of patients living with brain metastases or leptomeningeal disease (LMD). Disparities for Patients Living with BCBM & LMD In the US, approximately 200,000 new cases of brain metastases are diagnosed each year[1]. Approximately 10–15% of patients with MBC will develop brain metastases, and may be as high as 30–50% for certain subtypes[2]. A diagnosis of central nervous system (CNS) metastasis often accelerates an already incurable diagnosis. CNS metastasis are difficult to image and detect, tend to have poorer prognoses with lower overall survival, and are treated with invasive therapies which can have lasting side effects. Furthermore, most clinical trials exclude patients with CNS metastasis which further hinders research. Values and Objectives The overarching goal of this initiative is to accelerate the scope and breadth of evidence-based CNS metastasis research by targeting entities conducting clinical trials and collaborating with them to do the following: (i) Increase the quality and quantity of basic research; (ii) Increase the number of clinical trials in areas where research is lacking; (iii) Diversify the type of clinical trial interventions; (iv) Eliminate restrictive eligibility criteria in clinical trials; (v) Incorporate clinically meaningful trial endpoints [1] Eichler, April F et al. The biology of brain metastases-translation to new therapies. Nature reviews. Clinical oncology vol. 8,6 (2011): 344–56. doi: 10.1038/nrclinonc.2011.58 [2] Brosnan EM, Anders CK. Understanding patterns of brain metastasis in breast cancer and designing rational therapeutic strategies. Ann Transl Med. 2018;6(9):163. doi: 10.21037/atm.2018.04.35
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25

Pisani, P., G. Angeli, M. Krengli, and F. Pia. "Renal carcinoma metastasis to the parotid gland." Journal of Laryngology & Otology 104, no. 4 (1990): 352–54. http://dx.doi.org/10.1017/s0022215100112691.

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AbstractMetastatic tumours in major salivary glands are uncommon with a higher incidence of primary sites from the head and neck. The lungs and breast are the common primary sites, while metastases from the kidney are very rarely found. The authors describe a case of renal clear-cell carcinoma with metastastis to the parotid gland. The incidence of a metastasis in the parotid gland from a primary renal carcinoma, even if rare, should not be overlooked in making a correct differential diagnosis with acinic cell carcinoma and monomorphic clear cell adenoma.
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26

Kiyasu, Yoshiyuki, Ken Hayashi, Go Miyahara, and Makoto Narita. "Solitary Pancreatic Metastasis From Breast Matrix-Producing Carcinoma: A First Case Report." International Surgery 102, no. 7-8 (2017): 294–98. http://dx.doi.org/10.9738/intsurg-d-17-00064.1.

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Introduction: Breast matrix-producing carcinoma (MPC) is a rare histologic type. Pancreatic metastases from breast cancers are also rare. We report the first case of solitary pancreatic metastasis from breast MPC, treated with distal pancreatectomy. Case presentation: A 56-year-old woman presented with a 56-mm mass in her right breast and a swollen right axillary lymph node. Both lesions had characteristic early ring enhancement on dynamic magnetic resonance imaging (MRI). Tumor biopsy revealed MPC. She underwent total mastectomy and axillary clearance. On histopathologic examination, the tumor was composed of extracellular matrix with areas of osseous and chondroid differentiation without spindle cells or osteoclasts, surrounded by a dense population of glandular epithelial tumor cells. On immunohistochemical analysis, the tumor cells were positive for AE1/AE3 and cytokeratin 5/6. The final diagnosis was breast MPC with axillary metastasis. Two years later, dynamic MRI displayed a mass in the pancreatic body with early ring enhancement, suspicious for solitary breast MPC metastasis. Distal pancreatectomy was performed. Histopathologic examination revealed bone and cartilaginous matrix with necrosis, surrounded by pleomorphic sarcomatous tumor cells. Tumor cells showed less cytokeratin positivity than the primary breast lesion. These findings were compatible with breast MPC metastasis. Conclusion: Solitary pancreatic metastasis from breast MPC has not yet been reported. Surgical resection of malignant pancreatic metastases is controversial; however, considering that breast MPC has limited responsiveness to radiotherapy and chemotherapy, curative resection would be important in this case. The histopathologic features of MPC may reflect enhancement and calcification on radiologic studies.
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27

Hosonaga, Mari, Hideyuki Saya, and Yoshimi Arima. "Molecular and cellular mechanisms underlying brain metastasis of breast cancer." Cancer and Metastasis Reviews 39, no. 3 (2020): 711–20. http://dx.doi.org/10.1007/s10555-020-09881-y.

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Abstract Metastasis of cancer cells to the brain occurs frequently in patients with certain subtypes of breast cancer. In particular, patients with HER2-positive or triple-negative breast cancer are at high risk for the development of brain metastases. Despite recent advances in the treatment of primary breast tumors, the prognosis of breast cancer patients with brain metastases remains poor. A better understanding of the molecular and cellular mechanisms underlying brain metastasis might be expected to lead to improvements in the overall survival rate for these patients. Recent studies have revealed complex interactions between metastatic cancer cells and their microenvironment in the brain. Such interactions result in the activation of various signaling pathways related to metastasis in both cancer cells and cells of the microenvironment including astrocytes and microglia. In this review, we focus on such interactions and on their role both in the metastatic process and as potential targets for therapeutic intervention.
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Valenza, Carmine, Francesca Maria Porta, Alessandra Rappa, et al. "Complex Differential Diagnosis between Primary Breast Cancer and Breast Metastasis from EGFR-Mutated Lung Adenocarcinoma: Case Report and Literature Review." Current Oncology 28, no. 5 (2021): 3384–92. http://dx.doi.org/10.3390/curroncol28050292.

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We present a case of a woman with epidermal growth factor receptor (EGFR)-mutated lung adenocarcinoma who received gefitinib for 2 years and obtained a partial response. The patient then developed liver metastasis and a breast lesion, displaying high estrogen receptor (ER) expression and harboring the same EGFR mutation. From the radiological studies, it was not possible to make a differential diagnosis between primary breast cancer and breast metastasis from lung cancer. After the removal of the breast nodule, thanks to the clinical history, radiology, and above all, molecular and immunohistochemical investigations, a diagnosis of breast metastasis from lung adenocarcinoma was made. This case emphasizes the importance of a comprehensive clinical, pathological, and molecular analysis in the differential diagnosis between primary breast cancer and metastases from extramammary tumor to guide adequate treatment decision making.
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Yazdani, Akram, and Hossein Akbari. "Association of CA 15-3 and CEA with Liver Metastases in Patients with Breast Cancer." Current Cancer Therapy Reviews 16, no. 4 (2020): 332–36. http://dx.doi.org/10.2174/1573394716666191216112938.

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Objective: The liver is the second most common site of distant metastasis from breast cancer that is usually associated with poor prognosis and low quality of life in breast cancer patients. Therefore, the primary diagnosis of liver metastatic lesions in breast cancer patients is very important. In this study, the ability of biochemical markers CA153, CEA, and ALP to be used for prognostic liver metastasis in women with breast cancer was investigated. Methods: 306 women with breast cancer recorded between 2008 and 2012 were included. Serum concentrations of alkaline phosphatase (ALP), carcinogenicity antigen (CEA), cancer antigen (CA-153), age, menopausal status, histologic type, tumor size and number of cancerous axillary lymph nodes in two groups of breast cancer women with liver metastases and without it were studied. To identify independent liver metastasis prognostic factors, logistic regression method was applied. Results: The independent prognostic factors of liver metastases in women with breast cancer are ALP, CEA, age, menopausal status, number of cancerous axillary lymph nodes and tumor size. Sensitivity and specificity analysis showed that CEA with a cutoff value of 1.1 was the most accurate predictive factor. Conclusion: The increase in the levels of CEA and ALP can be diagnostic markers for liver metastases from breast cancer.
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Welm, Alana L., Julie B. Sneddon, Carmen Taylor, et al. "The macrophage-stimulating protein pathway promotes metastasis in a mouse model for breast cancer and predicts poor prognosis in humans." Proceedings of the National Academy of Sciences 104, no. 18 (2007): 7570–75. http://dx.doi.org/10.1073/pnas.0702095104.

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A better understanding of tumor metastasis requires development of animal models that authentically reproduce the metastatic process. By modifying an existing mouse model of breast cancer, we discovered that macrophage-stimulating protein promoted breast tumor growth and metastasis to several organs. A special feature of our findings was the occurrence of osteolytic bone metastases, which are prominent in human breast cancer. To explore the clinical relevance of our model, we examined expression levels of three genes involved in activation of the MSP signaling pathway (MSP, MT-SP1, and MST1R) in human breast tumors. We found that overexpression of MSP, MT-SP1, and MST1R was a strong independent indicator of both metastasis and death in human breast cancer patients and significantly increased the accuracy of an existing gene expression signature for poor prognosis. These data suggest that signaling initiated by MSP is an important contributor to metastasis of breast cancer and introduce an independent biomarker for assessing the prognosis of humans with breast cancer.
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Bhandari, Virendra, Saadvik Raghuraman, Kanchan Singh, and Sweta Kaushik. "Orbital Metastasis as the Presenting Feature of Carcinoma Breast." Indian Journal of Cancer Education and Research 4, no. 2 (2016): 67–70. http://dx.doi.org/10.21088/ijcer.2321.9815.4216.5.

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32

Basaran, Recep, Mehmet Tiryaki, Dilek Yavuzer, Mustafa Efendioglu, Ece Balkuv, and Aydin Sav. "Spinal Intramedullary Metastasis of Breast Cancer." Case Reports in Medicine 2014 (2014): 1–3. http://dx.doi.org/10.1155/2014/583282.

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Objective.Breast cancer accounts for approximately one-third of all cancers in females. Approximately 8.5 % of all central nervous system metastases are located in the spinal cord. These patients have rapidly progressing neurological deficits and require immediate examination. The aim of surgery is decompression of neural tissue and histological evaluation of the tumor. In this paper, we present a case of breast cancer metastasis in thoracic spinal intramedullary area which had been partially excised and then given adjuvant radiotherapy.Case.A 43-year-old female patient with breast cancer for 8 years was admitted to our hospital with complaints of weakness in both legs. Eight years ago, she received chemotherapy and radiotherapy. On her neurological examination, she had paraparesis (left lower extremity: 2/5, right lower extremity: 3/5) and urinary incontinence. Spinal MRI revealed a gadolinium enhancing intramedullary lesion. Pathologic examination of the lesion was consistent with breast carcinoma metastasis. The patient has been taken into radiotherapy.Conclusion.Spinal intramedullary metastasis of breast cancer is an extremely rare situation, but it has a high morbidity and mortality rate. Microsurgical resection is necessary for preservation or amelioration of neurological state and also for increased life expectancy and quality.
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Srirajaskanthan, R., K. Desai, A. Jayaratnam, et al. "Uncommon sites for metastasis of neuroendocrine tumor in adults." Journal of Clinical Oncology 27, no. 15_suppl (2009): e15683-e15683. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e15683.

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e15683 Background: Neuroendocrine tumours are relatively slow growing tumours. They often present with significant metastatic disease affecting liver, lymph nodes, lungs and bone. However tumour masses may be found at unusual/uncommon sites e.g. breast, orbital soft tissue and the heart raising the possibility of this being metastatic focus or presence of another primary tumour. Detection of these sites could have a significant impact on the available treatment options. Aim: to determine the most appropriate imaging modality and type of tumour metastases. Methods: We reviewed 300 consecutive clinic patients. We identified 18 patients with metastasis at uncommon sites i.e. breast, orbital and cardiac. We retrospectively evaluated clinical notes and recent radiological investigations of these patients. To characterise these lesions additional investigations included cross sectional imaging, PET imaging (68Gallium DOTA Octreotate PET and 18F- FDG PET) and histological evaluation of the metastasis where appropriate. Patients with breast metastasis underwent bilateral mammogram, patients with peri-ocular involvement underwent MRI of the brain and the orbit. Results: 18 patients had tumour masses at uncommon sites. Of these 15 masses were in the breast; 4 were in the orbital muscles and 2 patients had pericardial metastasis. Of the 15 patients with breast lesions 12 had confirmed neuroendocrine tumour metastases and 3 had breast cancer. It should be noted that breast cancer lesions were positive on the 68Gallium Octreotate PET imaging. One patient who had a defined metastasis in the pericardium showed avid uptake on the 68Gallium DOTA Octreotate PET and scan and cardiac MRI, the other patient had pericardial metastases confirmed at post mortem. Conclusions: Clear knowledge of these uncommon sites of metastasis is useful in terms of arranging further investigations and excluding other cancers. It is also important to realise that although somatostatin receptor scintigraphy especially 68Gallium DOTA Octreotate PET is very useful in detecting NET metastasis, it may also show avid uptake in patients with breast cancer and hence histological evaluation of these lesions are important. Undoubtedly within our cohort of patients and generally there is an under-diagnosis of lesions in uncommon sites. No significant financial relationships to disclose.
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Critchley, Adam Charles, James Harvey, Michael Carr, and Obi Iwuchukwu. "Synchronous gastric and colonic metastases of invasive lobular breast carcinoma: case report and review of the literature." Annals of The Royal College of Surgeons of England 93, no. 5 (2011): e49-e50. http://dx.doi.org/10.1308/147870811x582800.

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Breast cancer is the most common malignancy in women and the main cause of cancer death in the UK. Gastrointestinal (GI) tract metastasis and carcinomatosis from primary breast cancer are rare but breast cancer is the second most common primary malignancy to metastasise to the GI tract after malignant melanoma. The metastatic patterns of invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC) have been shown to differ considerably. Liver, lung and brain metastases are more common in IDC. Most series report a greater prediliction for lobular carcinoma to metastasise to the GI tract, gynaecological organs or peritoneum. The presentation of GI metastasis due to breast cancer is typically vague and the clinical, radiological, endoscopic and histopathologic findings are often difficult to distinguish from primary gastric carcinoma. Such a patient is more likely to present to a luminal surgeon or gastroenterologist than a breast surgeon. Therefore a high index of clinical suspicion with early endoscopy in those with non-specific symptoms and a past history of breast cancer, particularly ILC, are recommended. It is imperative to differentiate between metastatic breast cancer and primary gastric carcinoma as treatment strategies differ hugely. Therefore, correlation of endoscopic biopsy histology with the primary breast cancer histology is essential. Treatment modalities are limited to appropriate systemic therapy, which may have a palliative effect in up to 50%. Surgical intervention is nearly always limited to palliative bypass only. Prognosis is consistent with the median survival of all women with metastatic disease secondary to breast cancer.
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Brady, Claire, Richard Martin Bambury, Jodie E. Battley, et al. "Resection of breast cancer brain metastases: A single institution experience." Journal of Clinical Oncology 30, no. 15_suppl (2012): e11569-e11569. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e11569.

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e11569 Background: Resection of a single brain metastasis (SBM) in metastatic cancer has been shown to improve overall survival (OS). A previously reported series from MD Anderson of breast cancer patients undergoing SBM resection reported a median overall survival of 19 months. We report our experience of SBM resection for breast cancer. Methods: Retrospective observational study of patients who underwent resection of SBM from breast cancer brain in a tertiary referral centre from 2000-2011. Results: 20 patients underwent SBM resection from 2000-2011. All patients received WBRT after surgery. 2 patients had progressive metastatic disease presenting as brain metastases. Median time from original breast cancer diagnosis to development of SBM was 53 months (range:1-286months). 9 patients had solitary brain metastases (no metastases elsewhere) and 11 patients had synchronous metastases elsewhere. Regarding the primary breast tumour: 41% of patients were ER+, 57% were HER2+ and 25% were triple negative. 1 patient had discordance of ER status between the primary tumour and brain metastasis (changed from ER- to ER+). Median overall survival was 9 months (95% CI: 5-18 months) with 1 year OS of 50%, 2 year OS of 15% and 3 year OS of 5%. Patients treated between 2006-2011 had better median OS than those treated 2000-2005(18 months vs 6 months – p-value not significant). Patients with a solitary brain metastasis had better median OS than those with synchronous extracranial disease (13 months vs 6 months – p-value not significant). An additional 2 patients underwent craniotomy for presumed breast cancer metastasis but histology revealed glioblastoma multiforme. Conclusions: We report on a cohort of patients undergoing metastatectomy for single brain metastasis from breast cancer. Median OS was 9 months but there was a trend towards better survival in patients treated in recent years when compared with those treated from 2000-2005. Improved systemic therapies may account for this difference. Also of note 2 patients undergoing resection for presumed brain metastases were found to have GBM, highlighting the role of tissue diagnosis in patients presenting with a solitary brain lesion.
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Han, W., H. Kim, J. Lee, et al. "Value of preoperative staging of breast cancer patients using computed tomography to detect asymptomatic lung and liver metastasis." Journal of Clinical Oncology 27, no. 15_suppl (2009): 1105. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.1105.

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1105 Background: Preoperative clinical staging in breast cancer patients is important to determine the most appropriate treatment plans and to predict prognosis for individual patients. Identifying unexpected distant metastases in newly diagnosed breast cancer patients frequently alters initial treatment plans. Routine imaging studies to detect lung or liver metastasis is not indicated in patients with early and operable breast cancer. A recent study showed that routine use of chest radiograph and liver ultrasound does not provide much diagnostic benefit in early breast cancer patients. Methods: We aimed to investigate the value of preoperative computed tomography to detect asymptomatic liver and lung metastasis in breast cancer patients. We performed preoperative CT for 667 breast cancer patients to detect lung and liver metastasis among 1,636 primary breast cancer patients who had been diagnosed and treated between January 2006 and December 2007 at Seoul National University Hospital. Results: CT showed abnormal findings (suspicious of metastasis or indeterminate nodules) in 78 patients (10.5%). Among these, abnormal finding in 13 patients (1.7%) turned out to be true metastatic lesions. There was no CT-detected lung or liver metastasis in patients with T1 tumor and 4 metastases in patients with T2 tumor. There was no CT-detected lung or liver metastasis in patients with negative axillary lymph node metastasis. When patients were classified according to the AJCC staging, CT-detected true metastatic lesions were only present in stage III patients (13 out of 173 patients, 7.5%). The true metastatic lesions in lung or liver were all small sized nodules, ranging from 0.3cm to 1.2cm in largest diameters. In seven patients, the CT-detected metastatic lesions were less than 1cm which is in contrast with the previous studies. Conclusions: Our results demonstrated the lack of usefulness in performing routine CT exams to detect asymptomatic liver and lung metastasis in early breast cancer patients. Staging CT might be useful in stage III patients, since 13 (7.5%) patients were upstaged to stage IV by the use of CT. No significant financial relationships to disclose.
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Solaini, Leonardo, Anna Bianchi, Luigi Filippini, Laura Lucini, Edda Simoncini, and Fulvio Ragni. "A Mammary Nodule Mimicking Breast Cancer." International Surgery 99, no. 3 (2014): 200–202. http://dx.doi.org/10.9738/intsurg-d-12-00019.1.

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Abstract Metastases to the breast from extramammary tumors are rare. Several clinical, radiologic, and histologic signs can help to distinguish metastases from breast primary tumors. In the present study, we present a case of a left-sided breast metastasis from renal cancer in a 44-year-old woman whose clinical presentation was a mammary nodule in the upper internal quadrant. The patient underwent quadrantectomy with sentinel lymph node biopsy. The histology revealed a clear cell carcinoma. On computed tomography scan a 5×8-cm left renal mass with pulmonary, liver, and intrapericardial nodules was found. The patient underwent palliative care and died after 4 months. Metastasis to the breast is rare, but all of those clinical, radiologic, and histologic signs more typical of extramammary malignancies should always be considered in order to choose the best treatment strategy.
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Oktay, Esin, Özlem Yersal, Nezih Meydan, Mehmet Sağıroğlu, Ömer Uyanık, and Sabri Barutca. "Nearly Complete Response of Brain Metastases from HER2 Overexpressing Breast Cancer with Lapatinib and Capecitabine after Whole Brain Irradiation." Case Reports in Oncological Medicine 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/234391.

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Trastuzumab treatment does not prevent intracranial seeding and is largely ineffective for established central nervous system metastasis in HER2 overexpressing breast cancer patients. Combination therapy of lapatinib and capecitabine may be an effective treatment option for brain metastasis of HER2-positive breast cancer. We report a patient with breast cancer overexpressing HER-2 where brain metastases were successfully treated with radiation and a combination of lapatinib and capecitabine.
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39

Cormio, Luigi, Francesca Sanguedolce, Giuseppe Di Fino, et al. "Asymptomatic Bladder Metastasis from Breast Cancer." Case Reports in Urology 2014 (2014): 1–3. http://dx.doi.org/10.1155/2014/672591.

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Introduction.Breast cancer is the most common nondermatologic cancer in women. Common metastatic sites include lymph nodes, lung, liver, and bone. Metastases to the bladder are extremely rare, with all reported cases presenting with urinary symptoms.Case Report.Herein, we report the first case of completely asymptomatic bladder metastasis from breast cancer, occasionally revealed, 98 months after the initial diagnosis of lobular breast carcinoma, by a follow-up computed tomography scanning showing thickening of left bladder wall and grade II left hydronephrosis. A positive staining for estrogen and progesterone receptors was confirmed by immunohistochemistry.Discussion.The reported case confirms that bladder metastases from breast cancer tend to occur late after the diagnosis of the primary tumor and, for the first time, points out they can be asymptomatic.Conclusion.Such data support the need for careful follow-up and early intervention whenever such clinical situation is suspected.
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40

Cavazzini, Giovanna, Francesco Colpani, Maurizio Cantore, et al. "Breast Metastasis from Gastric Signet Ring Cell Carcinoma, Mimicking Inflammatory Carcinoma. A Case Report." Tumori Journal 79, no. 6 (1993): 450–53. http://dx.doi.org/10.1177/030089169307900617.

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We report a case of breast metastasis of signet ring cell gastric cancer clinically presented as a primary inflammatory carcinoma. Metastases to the breast are uncommon; review of the literature demonstrated only 300 cases. The clinical and radiographic features of the metastatic lesion were unlike those reported in the literature. Although a primary signet ring cell breast carcinoma was described, the pathologic patterns of the breast lesion, here reported, lead us to conclude this was a metastasis and not another primary tumor.
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Zhao, F.-L., G.-D. Hu, X.-F. Wang, X.-H. Zhang, Y.-K. Zhang, and Z.-S. Yu. "Serum Overexpression of MicroRNA-10b in Patients with Bone Metastatic Primary Breast Cancer." Journal of International Medical Research 40, no. 3 (2012): 859–66. http://dx.doi.org/10.1177/147323001204000304.

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OBJECTIVE: Bone metastasis is a major complication of advanced breast cancer. The present prospective case—control study investigated the involvement of microRNA (miR)-10b in the development of bone metastasis arising from primary breast carcinoma. METHODS: Serum miR-10b concentrations were determined by quantitative real-time reverse transcription—polymerase chain reaction in 122 patients with breast cancer, with or without bone metastases, and 59 age-matched healthy control subjects. RESULTS: Serum miR-10b concentrations were significantly higher in patients with bone metastases than in patients without bone metastases or control subjects. Serum miR-10b had an area under the receiver operating characteristic curve for the presence of bone metastases of 0.769, with 64.8% sensitivity and 69.5% specificity. CONCLUSION: These results suggest that serum miR-10b may be a useful biomarker for the identification of bone metastatic breast cancer.
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RODRIGUES, Marcus Vinicius Rozo, Valdir TERCIOTI-JUNIOR, Luiz Roberto LOPES, João de Souza COELHO-NETO, and Nelson Adami ANDREOLLO. "BREAST CANCER METASTASIS IN THE STOMACH: WHEN THE GASTRECTOMY IS INDICATED ?" ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 29, no. 2 (2016): 86–89. http://dx.doi.org/10.1590/0102-6720201600020005.

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ABSTRACT Background: Breast cancer is the most common malignant neoplasm in the female population. However, stomach is a rare site for metastasis, and can show up many years after initial diagnosis and treatment of the primary tumor. Aim: Analyze a case series of this tumor and propose measures that can diagnose it with more precocity. Methods: Were analyzed 12 patients with secondary gastric tumors. Immunohistochemistry has demonstrated that primary tumor was breast cancer. We retrieved information of age, histological type, interval between diagnosis of the primary breast cancer and its metastases, immunohistochemistry results, treatment and survival. Results: The mean age was 71.3 years (ranging 40-86). Ten cases had already been underwent mastectomy in the moment of the diagnosis of gastric metastasis. Two patients had diagnosis of both primary and secondary tumors concomitantly. At average, diagnosis of gastric metastasis was seven years after diagnosis of primary breast cancer (ranging 0-13). Besides, nine cases had also metastases in other organs, being bones the most affected ones. Immunohistochemistry of the metastases has shown positivity for CK7 antibody in 83.34%, estrogen receptor in 91.67%, progesterone receptor in 66.67% and AE1AE3 antibody in 75%, considering all 12 cases. Moreover, CK20 was absent significantly (66.67%). The positivity of BRST2 marker did not present statistical significance (41.67%). Eight cases were treated with chemotherapy associated or not with hormonal blockade. Surgical treatment of gastric metastasis was performed in four cases: three of them with total gastrectomy and one with distal gastrectomy. Follow-up has shown a mean survival of 14.58 months after diagnosis of metastasis, with only two patients still alive. Conclusion: Patients with a history of breast cancer presenting endoscopic diagnosis of gastric cancer it is necessary to consider the possibility of gastric metastasis of breast cancer. The confirmation is by immunohistochemistry and gastrectomy should be oriented in the absence of other secondary involvement and control of the primary lesion.
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43

Vona-Davis, Linda, David P. Rose, Vijaya Gadiyaram, et al. "Breast Cancer Pathology, Receptor Status, and Patterns of Metastasis in a Rural Appalachian Population." Journal of Cancer Epidemiology 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/170634.

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Breast cancer patients in rural Appalachia have a high prevalence of obesity and poverty, together with more triple-negative phenotypes. We reviewed clinical records for tumor receptor status and time to distant metastasis. Body mass index, tumor size, grade, nodal status, and receptor status were related to metastatic patterns. For 687 patients, 13.8% developed metastases to bone (n=42) or visceral sites (n=53). Metastases to viscera occurred within five years, a latent period which was shorter than that for bone (P=0.042). More women with visceral metastasis presented with grade 3 tumors compared with the bone and nonmetastatic groups (P=0.0002). There were 135/574 women (23.5%) with triple-negative breast cancer, who presented with lymph node involvement and visceral metastases (68.2% versus 24.3%;P=0.033). Triple-negative tumors that metastasized to visceral sites were larger (P=0.007). Developing a visceral metastasis within 10 years was higher among women with triple-negative tumors. Across all breast cancer receptor subtypes, the probability of remaining distant metastasis-free was greater for brain and liver than for lung. The excess risk of metastatic spread to visceral organs in triple-negative breast cancers, even in the absence of positive nodes, was combined with the burden of larger and more advanced tumors.
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44

Li, Mao, Markus Schweiger, Ichiro Nakano, Daniel Ryan, Litia Carvalho, and Bakhos Tannous. "BSCI-16. Olfactory receptor 5B21 drives breast cancer metastasis." Neuro-Oncology Advances 3, Supplement_3 (2021): iii4. http://dx.doi.org/10.1093/noajnl/vdab071.015.

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Abstract Olfactory receptors (ORs), responsible for the sense of smell, play an essential role in physiological processes (even outside the nasal epithelium) and cancer. In breast cancer, however, the expression and role of ORs remain understudied. We examined the significance of ORs transcript abundance in breast cancer metastasis to different tissues including the brain, bone, and lung. While we found 20 OR genes to be differentially expressed in different metastasis versus primary tumor, OR5B21 displayed high relation with all metastases. Knockdown of OR5B21 significantly decreased the invasion and migration of breast cancer cells in culture as well as metastasis to different organs including the brain, in vivo. On the other hand, overexpression of OR5B21 in the primary cells had the opposite effect. Mechanistically, OR5B21 was associated with epithelial to mesenchymal transition through STAT3/NFkB/CEBPβ signaling pathway. We propose OR5B21 (and potentially other ORs) as a novel oncogene contributing to breast cancer metastasis, and as a potential target for therapy.
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45

Davies, Timothy, Tarak Chouari, Christopher Ray, and Suzanne Elgammal. "Appendiceal adenocarcinoma with breast metastases." BMJ Case Reports 14, no. 5 (2021): e240808. http://dx.doi.org/10.1136/bcr-2020-240808.

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Malignant lesions of the vermiform appendix make up a rare subset of colorectal cancer. While colorectal cancer frequently metastasises to the liver, lung, regional lymph nodes and peritoneum, metastasis to the breast is extremely rare. Here, we describe the case of an 84-year-old woman who had the incidental finding of appendiceal adenocarcinoma following emergency laparoscopic appendectomy. She declined further operative or adjuvant treatment for her disease. She represented 1 year later with metastatic appendiceal adenocarcinoma disease to her left breast. A simple mastectomy for symptomatic treatment was performed. In this report, we describe the first case of appendiceal adenocarcinoma metastases to the breast. Due to its rarity, there is a paucity of evidence related to the management of this condition. The limited evidence is reviewed and discussed.
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Tulotta, Claudia, and Penelope Ottewell. "The role of IL-1B in breast cancer bone metastasis." Endocrine-Related Cancer 25, no. 7 (2018): R421—R434. http://dx.doi.org/10.1530/erc-17-0309.

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Approximately 75% of patients with late-stage breast cancer will develop bone metastasis. This condition is currently considered incurable and patients’ life expectancy is limited to 2–3 years following diagnosis of bone involvement. Interleukin (IL)-1B is a pro-inflammatory cytokine whose expression in primary tumours has been identified as a potential biomarker for predicting breast cancer patients at increased risk for developing bone metastasis. In this review, we discuss how IL-1B from both the tumour cells and the tumour microenvironment influence growth of primary breast tumours, dissemination into the bone metastatic niche and proliferation into overt metastases. Recent evidence indicates that targeting IL-1B signalling may provide promising new treatments that can hold tumour cells in a dormant state within bone thus preventing formation of overt bone metastases.
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Washam, Charity L., Stephanie D. Byrum, Kim Leitzel, Ali M. Suhail, Allan Lipton, and Larry J. Suva. "PTHrP(12-48) for the diagnosis of breast cancer bone metastasis." Journal of Clinical Oncology 30, no. 15_suppl (2012): e21039-e21039. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e21039.

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e21039 Background: Bone metastasis of breast cancer significantly compromises patient morbidity and mortality. Currently, no reliable methods detect or predict patients at increased risk for developing bone metastasis. We utilized 3 independent cohorts of breast cancer patients to validate a highly discriminatory plasma-based proteomic profile that identifies breast cancer bone metastasis. The identity of the most discriminatory protein component identified was a parathyroid hormone-related protein fragment, PTHrP(12-48). Methods: Plasma samples collected from 21 breast cancer patients with clinical evidence of a bone metastasis and 21 patients with no evidence of bone metastasis from time of diagnosis to clinical outcome were evaluated. A novel mass spectrometry-based assay using human serum spiked with synthetic PTHrP(12-48) was used to measure PTHrP(12-48) concentrations (pg/μl). Statistical significance was assessed by one-way ANOVA. ROC curves evaluated the diagnostic potential of PTHrP(12-48) and a simple logistic regression derived from the combined measurement of PTHrP(12-48) and NTx. Results: PTHrP(12-48) concentrations ranged between 11.6 and 92.1 pg/μl in bone metastasis patients and between 4.5 and 34.2 pg/μl in patients without bone metastases. PTHrP(12-48) was significantly increased in bone metastasis plasma (p < 0.05). No significant correlation was identified between PTHrP(12-48) and NTx. ROC analysis of PTHrP(12-48), threshold 18 pg/μl, classified the two groups with high accuracy. Class prediction by the PTHrP(12-48)/NTx logistic regression model increased diagnostic specificity. Conclusions: The measurement of PTHrP(12-48) in patient plasma has potential as a viable clinical measure of bone metastasis. In combination with serum NTx, PTHrP(12-48) may assist in identifying bone metastases in patients presenting with low to normal bone turnover markers.
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Fukumura, Kazutaka, Xizeng Mao, Xingzhi Song, et al. "BSCI-12. COMPREHENSIVE GENOMIC ANALYSIS OF BRAIN METASTASES FROM MULTIPLE CANCER TYPES." Neuro-Oncology Advances 1, Supplement_1 (2019): i3. http://dx.doi.org/10.1093/noajnl/vdz014.010.

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Abstract PURPOSE: Brain metastases occur in approximately 8–10% of patients with cancer, and the incidence has increased over the past decades. The most common primary tumors responsible for brain metastases are lung cancer, melanoma, renal cell carcinoma (RCC), breast cancer and colorectal cancer. The precise mechanisms by which genomic and transcriptional abnormalities drive the formation of brain metastases remain unclear. Here, we conducted comprehensive genomic and transcriptional analysis with paired primary tumor tissue (or extracranial metastasis tissue) and brain metastasis tissue using whole-exome sequencing (WES), mRNA-Seq and global methylation profiling. METHODS: Frozen, paired brain metastasis tissue and primary tumor tissue (or extracranial metastasis tissue) and white blood cells were acquired from RCC (n=12), breast cancer (n=17), lung cancer (n=15) and melanoma (n=14) patients, followed by extraction of DNA and RNA. WES and mRNA-Seq were performed on the Illumina HiSeq4000 platform. For methylation profiling, DNA was analyzed using Illumina Infinium MethylationEPIC Beadchip arrays. RESULTS: Somatic mutations or methylation of VHL gene were identified in 81.8% of RCC patients. Gene Set Enrichment Analysis revealed significant enrichment for hypoxia pathway transcripts in RCC brain metastases relative to primary tumors. The most common alterations in breast and lung cancer patients were TP53 mutations with frequencies of 50.0% and 73.3%, followed by ERBB2 alterations (43.8%) in breast cancer patients and mutually exclusive alterations of EGFR (33.3%) and KRAS (26.7%) in lung cancer patients. Mutually exclusive alterations of NRAS (42.9%) and BRAF (42.9%) were also observed in melanoma patients. Gene expression and epigenetic analysis revealed characteristics of brain metastases depending on primary cancer types. CONCLUSIONS: Comprehensive genomic analysis of brain metastases from four different cancer types revealed that brain metastasis tissues have unique genomic, transcriptional and epigenetic profiles according to histopathology groups. Therefore, the therapeutic strategies should be designed based at least in part on tumor histiogenesis.
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Hajjaji, Nawale, Mira Abbouchi, Lan Anh Nguyen, et al. "A novel proteomic mass spectrometry-based approach to reveal functionally heterogeneous tumor clones in breast cancer metastases and identify clone-specific drug targets." Journal of Clinical Oncology 38, no. 15_suppl (2020): e13063-e13063. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e13063.

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e13063 Background: Breast cancer mortality is expected to rise by almost 30% by 2030 worldwide, mainly due to the occurrence of distant metastases. The development of drugs specifically targeted at tumor drivers has not yet curbed resistance to treatment, which prevents metastases curability. There is a need for new molecular approaches to tackle metastases complex biology, particularly tumor heterogeneity, a main determinant of resistance. The aim of this study was to use a proteomic mass spectrometry-based approach to reveal functionally heterogeneous’ tumor subpopulations in breast cancer metastases, and identify clone specific drug targets. Methods: Metastasis biopsies (n = 21) were collected retrospectively from patients with advanced breast cancer treated at Oscar Lambret Cancer Center (Lille, France). Tumor heterogeneity was analyzed directly on FFPE tissue sections using MALDI mass spectrometry imaging (MSI) on a RapifleX Tissuetyper. Unsupervised spatial segmentation was performed to reveal tumor subpopulations with distinct proteomic profiles within each metastasis. The full proteomic characterization of these tumor clones was further performed with spatially resolved proteomic mass spectrometry. Results: MSI revealed that breast cancer metastases contained 2 to 5 functionally distinct tumor clones (proteomic clones). Although the clone profiles within a metastasis were correlated, unsupervised hierarchical clustering showed a clear distinction between them and specific proteomic signatures. Enrichment analysis showed that differentially expressed proteins were involved in a variety of biological processes or pathways including regulation of histone acetylation, extracellular matrix degradation, DNA repair, NOTCH pathway, estrogen-responsive target genes or exocytosis. The evolution of the proteomic clones profile during disease progression was also determined by comparison of paired biopsies. To identify the candidate treatments best fitted to metastasis heterogeneity, the specific proteomic signatures of the clones were matched against a druggable genome database. It was possible to unveil candidate drug targets personalized to each metastasis functional clone. Conclusions: MALDI mass spectrometry imaging combined with spatially resolved proteomics has the potential to tackle breast cancer metastases heterogeneity, and identify candidate drug targets specific to functional clones to personalize treatments.
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Hiller, David, and Quyen D. Chu. "CXCR4 and Axillary Lymph Nodes: Review of a Potential Biomarker for Breast Cancer Metastasis." International Journal of Breast Cancer 2011 (2011): 1–6. http://dx.doi.org/10.4061/2011/420981.

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CXCR4 is a 7-transmembrane G-protein chemokine receptor that allows for migration of hematopoietic cells from the bone marrow to the peripheral lymph nodes. Research has shown CXCR4 to be implicated in the invasion and metastasis of several cancers, including carcinoma of the breast. CXCL12 is the ligand for CXCR4 and is highly expressed in areas common for breast cancer metastasis, including the axillary lymph nodes. Axillary lymph nodes positive for breast carcinoma have been an important component of breast cancer diagnosis, treatment, and subsequent research. The goal of this paper is to analyze the literature that has explained the pathways from CXCR4 expression to breast cancer metastasis of the lymph nodes and the prognostic and/or predictive implications of lymph node metastases in the presence of elevated CXCR4.
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