Long-term survival after pancreatic metastasis resection from breast cancer: a systematic literature review

Abstract

Background: Patients with advanced-stage breast cancer often demonstrate pancreatic metastases. However, pancreatic metastases resection from breast cancer has been rarely performed, with only 20 cases having been reported to date.

Case presentation: A 49-year-old woman presented to our hospital in September 2003 with complaints of uncontrollable oozing from her left breast tumor. Computed tomography revealed a left breast tumor approximately 9.3 cm in diameter as well as heterogeneously enhanced solid mass lesions with necrotic foci in the pancreatic tail and body, up to 6.2 cm, which were radiologically diagnosed as pancreatic metastases from breast cancer. An emergent left simple mastectomy was performed to control bleeding. After epirubicin and cyclophosphamide hydrate treatment failed to improve her condition, the pancreatic metastases responded to weekly paclitaxel treatment, but eventually regrew. The patient underwent distal pancreatectomy with splenectomy, left adrenalectomy, partial stomach resection, and paraaortic lymph nodes excision in December 2004 after no other metastasis was confirmed. Furthermore, she received radiation therapy for left parasternal lymph node metastasis 6 months later. The patient recovered well. Consequently, she has no evidence of disease > 15 years after pancreatectomy.

Conclusions: This is the first reported case of pancreatectomy for pancreatic metastases from breast cancer, which was simultaneously diagnosed. Patients with no metastasis other than resectable pancreatic metastases and breast cancer and who possess some sensitivity for chemotherapy may benefit from pancreatectomy.

Keywords: Breast cancer; Oligometastases; Pancreatectomy; Pancreatic metastasis.

Fig. 1

Pancreatic metastases and paraaortic lymph node metastases. Late arterial phase of dynamic contrast-enhanced computed tomography showing heterogeneously enhanced multiple solid mass lesions with necrotic foci in the pancreatic tail and body up to 6.2 cm (arrow) with peripancreatic and paraaortic lymph nodes swelling (arrowhead)

Fig. 2

Left breast cancer. Contrast-enhanced computed tomography showing the tumor projecting to the skin, approximately 9.3 cm in diameter

Fig. 3

Histology of left breast cancer. The tumor is composed of large nests with central comedo necrosis. The tumor cells have large round vesicular nuclei, prominent nucleoli, and pale eosinophilic granular cytoplasm

Fig. 4

Histology of the metastatic pancreatic tumor. The tumor, composed of large nests, invades the pancreas. The tumor cells have large round vesicular nuclei, prominent nucleoli, and pale eosinophilic granular cytoplasm