{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T15:10:22Z","timestamp":1781277022835,"version":"3.54.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Breast cancer (BC) is the second leading cause of cancer-related death in women, with mortality primarily associated with metastasis. Although gastric metastasis is rare, there are still case reports in the literature. Clinical symptoms of gastric metastasis from BC are often nonspecific, and endoscopic presentations are heterogeneous. Distinguishing between primary and metastatic tumors is important and challenging for the endoscopist. Herein, we report a case of gastric metastasis occurring 4 years after BC surgery. The timeline is as follows. In 2019, the 60-year-old woman received neoadjuvant chemotherapy followed by left breast radical surgery and endocrine therapy with targeted treatment. In 2022 (3 years post-surgery), left axillary metastasis was diagnosed, requiring excision of a skin mass. In 2023 (4 years post-surgery), she presented with upper abdominal pain and acid reflux, and gastroscopy revealed a superficial flat lesion in the gastric antrum. Immunohistochemical (IHC) staining suggested the possibility of poorly differentiated adenocarcinoma. Contrast-enhanced computed tomography (CT) revealed focal abnormal enhancement of the gastric antrum without evidence of distant metastasis. Since endoscopic, imaging, and IHC staining findings did not clearly suggest BC metastasis, and considering the patient\u2019s history of BC and overall condition, she underwent endoscopic submucosal dissection (ESD)-a procedure performed with both diagnostic and therapeutic intent. The postoperative pathology revealed metastatic invasive lobular carcinoma (ILC) of the breast. The ESD not only clarified the patients\u2019 diagnosis but also avoided unnecessary surgery for the patient. The patient remains alive under maintenance therapy. In summary, our case highlights the role of ESD, which was performed with both diagnostic and therapeutic intent\u2014in managing gastric metastasis from BC, while underscoring the necessity of regular endoscopic surveillance post-mastectomy.<\/jats:p>","DOI":"10.3389\/fonc.2025.1573163","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T04:14:13Z","timestamp":1747887253000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Breast cancer metastases to the stomach with endoscopic submucosal dissection: a case report and literature study"],"prefix":"10.3389","volume":"15","author":[{"given":"Qingmiao","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizhou","family":"Dou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolong","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guiqi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.11920","article-title":"An uncommon presentation of a common disease: A review of gastric metastasis from breast carcinoma","volume":"12","author":"Geada","year":"2020","journal-title":"Cureus"},{"key":"B2","doi-asserted-by":"publisher","first-page":"997","DOI":"10.5152\/tjg.2019.18649","article-title":"Report of two cases and a systematic review of breast cancer with gastrointestinal metastasis","volume":"30","author":"Zhong","year":"2019","journal-title":"Turk J Gastroenterol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1186\/s12905-023-02267-6","article-title":"First diagnosed invasive lobular carcinoma of the breast combined with gastric metastasis and bone metastasis: a case report and review of the literature","volume":"23","author":"Sun","year":"2023","journal-title":"BMC Womens Health"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.65852","article-title":"Gastrointestinal metastases from lobular breast carcinoma: A literature review","volume":"16","author":"Kioleoglou","year":"2024","journal-title":"Cureus"},{"key":"B5","article-title":"Linitis plastica as the first indication of metastatic lobular carcinoma of the breast: case report and literature review","volume":"42","author":"Ferri","year":"1999","journal-title":"Can J Surg"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2011.04.009","article-title":"Gastric metastasis of breast cancer: a single centre retrospective study","volume":"43","author":"Almubarak","year":"2011","journal-title":"Dig Liver Dis"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.04.026","article-title":"CARE guidelines for case reports: explanation and elaboration document","volume":"89","author":"Riley","year":"2017","journal-title":"J Clin Epidemiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1904","DOI":"10.1002\/cncr.v130.11","article-title":"Cancer Statistics 2024: Deaths drop, incidences increase, prevention needed","volume":"130","author":"Nierengarten","year":"2024","journal-title":"Cancer"},{"key":"B9","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1038\/s41416-020-01161-4","article-title":"The lingering mysteries of metastatic recurrence in breast cancer","volume":"124","author":"Riggio","year":"2021","journal-title":"Br J Cancer"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2017.07.003","article-title":"Lobular metastatic breast cancer patients with gastrointestinal involvement: features and outcomes","volume":"18","author":"Montagna","year":"2018","journal-title":"Clin Breast Cancer"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2005.03.030","article-title":"Breast cancer: presentation and intervention in women with gastrointestinal metastasis and carcinomatosis","volume":"12","author":"McLemore","year":"2005","journal-title":"Ann Surg Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2018.9754","article-title":"Clinical features and prognosis of breast cancer with gastric metastasis","volume":"17","author":"Hong","year":"2019","journal-title":"Oncol Lett"},{"key":"B13","doi-asserted-by":"publisher","first-page":"439023","DOI":"10.1155\/2012\/439023","article-title":"Metastatic breast cancer to the gastrointestinal tract: report of five cases and review of the literature","volume":"2012","author":"Ambroggi","year":"2012","journal-title":"Int J Breast Cancer"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.5306\/wjco.v12.i5.382","article-title":"Intestinal metastasis from breast cancer: Presentation, treatment and survival from a systematic literature review","volume":"12","author":"Bolzacchini","year":"2021","journal-title":"World J Clin Oncol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-014-3155-x","article-title":"Gastrointestinal manifestations of breast cancer metastasis","volume":"59","author":"Zhang","year":"2014","journal-title":"Dig Dis Sci"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s10585-016-9830-x","article-title":"Comparison of immunophenotypes of primary breast carcinomas and multiple corresponding distant metastases: an autopsy study of 25 patients","volume":"34","author":"Szekely","year":"2017","journal-title":"Clin Exp Metastasis"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v11.i14.3282","article-title":"Metastatic gastric cancer from breast carcinoma presenting with paraneoplastic rheumatic syndrome: A case report","volume":"11","author":"Rech","year":"2023","journal-title":"World J Clin Cases"},{"key":"B18","doi-asserted-by":"publisher","first-page":"2085452","DOI":"10.1155\/2016\/2085452","article-title":"Breast cancer metastasis to the stomach that was diagnosed after endoscopic submucosal dissection","volume":"2016","author":"Kita","year":"2016","journal-title":"Case Rep Gastrointest Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.12959","article-title":"Breast cancer metastasis to the stomach mimicking early gastric cancer","volume":"7","author":"Tanaka","year":"2023","journal-title":"JGH Open"},{"key":"B20","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1186\/1477-7819-5-75","article-title":"Breast cancer metastasis to the stomach may mimic primary gastric cancer: report of two cases and review of literature","volume":"5","author":"Jones","year":"2007","journal-title":"World J Surg Oncol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1186\/1477-7819-6-78","article-title":"Gastric metastases originating from occult breast lobular carcinoma: diagnostic and therapeutic problems","volume":"6","author":"Ciulla","year":"2008","journal-title":"World J Surg Oncol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.2174\/2212798409666171101121108","article-title":"The epithelial-mesenchymal transition pathway in two cases with gastric metastasis originating from breast carcinoma, one with a metachronous primary gastric cancer","volume":"13","author":"Gurzu","year":"2018","journal-title":"Recent Pat Anticancer Drug Discov"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000010258","article-title":"Gastric metastasis from invasive lobular breast cancer, mimicking primary gastric cancer: A case report","volume":"97","author":"Kim","year":"2018","journal-title":"Med (Baltimore)"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2017.6703","article-title":"Metastatic gastric cancer from breast carcinoma: A report of 78 cases","volume":"14","author":"Xu","year":"2017","journal-title":"Oncol Lett"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1430881","article-title":"Case report: Gastric metastasis of breast cancer","volume":"14","author":"Zhao","year":"2024","journal-title":"Front Oncol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1573163\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T04:14:13Z","timestamp":1747887253000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1573163\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,22]]},"references-count":25,"alternative-id":["10.3389\/fonc.2025.1573163"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1573163","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,22]]},"article-number":"1573163"}}