{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:14:50Z","timestamp":1783574090736,"version":"3.55.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"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>Small intestinal metastasis from breast cancer is a rare entity with non-specific clinical presentations, rendering it susceptible to missed or delayed diagnosis. Herein, we present a rare case of breast cancer metastasizing to the small bowel, with unexplained anemia as the sole initial clinical complaint.The patient manifested persistent dizziness and palpitations, accompanied by repeatedly positive fecal occult blood testing, and carried a well-documented history of surgical resection for bilateral breast malignancy.Contrast-enhanced computed tomography (CT) of the small bowel demonstrated segmental, asymmetric wall thickening with adjacent lymphadenopathy and no luminal stenosis; the thickened wall exhibited heterogeneous enhancement, raising initial suspicion of lymphoma. Subsequent double-balloon enteroscopy(DBE) identified a large circumferential deep ulcerative lesion, which was endoscopically indistinguishable from primary small bowel adenocarcinoma or intestinal lymphoma. The definitive diagnosis of small intestinal metastasis from breast cancer was established by histopathological and immunohistochemical evaluation, in conjunction with the patient\u2019s oncological history. A review of the literature indicates that small intestinal metastasis from breast cancer is more commonly associated with invasive lobular carcinoma, and affected patients usually present during routine surveillance or with abdominal pain. In the present case, the primary pathology was invasive ductal carcinoma of triple-negative phenotype (TNBC), and the patient\u2019s initial presentation with anaemia constitutes an atypical manifestation. Clinicians should maintain a high index of suspicion for small bowel metastasis in breast cancer survivors who develop unexplained anemia, positive fecal occult blood, or abnormal small intestinal imaging, even in the absence of classic gastrointestinal symptoms. A multidisciplinary approach integrating imaging, endoscopy, pathology, and immunohistochemistry is essential to minimise diagnostic delay and avoid misdiagnosis.<\/jats:p>","DOI":"10.3389\/fonc.2026.1900018","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:19:10Z","timestamp":1783570750000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Small intestinal metastasis of triple-negative breast cancer mimicking lymphoma: imaging findings and case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Lin-Ying","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Shan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Feng","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Ming","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-016-4059-6","article-title":"Triple-negative breast cancer has worse overall survival and cause-specific survival than non-triple-negative breast cancer","volume":"161","author":"Li","year":"2017","journal-title":"Breast Cancer Res Treat"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3233\/bd-2010-0311","article-title":"Small bowel obstruction from breast cancer metastasis: a case report and review of the literature","volume":"33","author":"Saied","year":"2011","journal-title":"Breast Dis"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23628","article-title":"Diagnosis and treatment of cancer-related anemia","volume":"89","author":"Gilreath","year":"2014","journal-title":"Am J Hematol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.4292\/wjgpt.v16.i2.105375","article-title":"Exploring the gut microbiome's influence on cancer-associated anemia: mechanisms, clinical challenges, and innovative therapies","volume":"16","author":"Bangolo","year":"2025","journal-title":"World J Gastrointest Pharmacol Ther"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/7611733","article-title":"Prevalence and associated factors of anemia among breast cancer patients undergoing chemotherapy: a prospective study","volume":"2022","author":"Muthanna","year":"2022","journal-title":"Adv Pharmacol Pharm Sci"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/bf02523990","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":"B8","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v13.i26.107496","article-title":"Gastrointestinal metastasis from invasive lobular carcinoma following breast cancer treatment: a case report","volume":"13","author":"Liu","year":"2025","journal-title":"World J Clin cases"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1101\/2025.06.20.660633","article-title":"CDH1 loss remodels gene expression and lineage identity in human mammary epithelial cells","author":"Musick","year":"2025","journal-title":"bioRxiv"},{"key":"B10","article-title":"Breast carcinoma with asymptomatic metastasis to the gallbladder","volume":"53","author":"Riaz","year":"2012","journal-title":"Singapore Med J"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1475018","article-title":"Small intestinal metastasis from primary breast cancer: a case report and review of literature","volume":"15","author":"Shen","year":"2024","journal-title":"Front Immunol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.74308","article-title":"A rare case of triple-positive breast cancer with eventual triple-negative small bowel metastasis","volume":"16","author":"Ngatuvai","year":"2024","journal-title":"Cureus"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.7812\/tpp\/20.244","article-title":"Duodenal metastasis in triple-negative invasive ductal breast carcinoma with negative mammography: a case report and review of the literature","volume":"25","author":"Khan","year":"2021","journal-title":"Perm J"},{"key":"B14","doi-asserted-by":"publisher","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":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/cnr2.70364","article-title":"Hepatocellular carcinoma with small bowel metastasis and intussusception: a case report and literature review","volume":"8","author":"Hsu","year":"2025","journal-title":"Cancer Rep (Hoboken)"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.rxeng.2020.11.008","article-title":"Diagnostic approach to small-bowel wall thickening: beyond Crohn's disease and cancer","volume":"63","author":"Marin-Diez","year":"2021","journal-title":"Radiologia (Engl Ed)"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-024-01793-z","article-title":"The target sign: a significant CT sign for predicting small-bowel ischemia and necrosis","volume":"129","author":"Li","year":"2024","journal-title":"Radiol Med"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-020-04730-3","article-title":"Surgical management of small bowel lymphoma","volume":"25","author":"Lu","year":"2021","journal-title":"J Gastrointest Surg"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-024-04201-2","article-title":"Multimodality imaging features of small bowel cancers complicating Crohn's disease: a pictorial review","volume":"49","author":"Paparo","year":"2024","journal-title":"Abdom Radiol (NY)"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izaf219","article-title":"Cross-sectional imaging features associated with disease progression in Crohn's disease","volume":"32","author":"Bachour","year":"2026","journal-title":"Inflammation Bowel Dis"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.12568","article-title":"Intestinal strictures in Crohn's disease: an update from 2023","volume":"12","author":"Liu","year":"2024","journal-title":"United Eur Gastroenterol J"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1900018\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:19:10Z","timestamp":1783570750000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1900018\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,9]]},"references-count":21,"alternative-id":["10.3389\/fonc.2026.1900018"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1900018","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,9]]},"article-number":"1900018"}}