AccScience Publishing / EJMO / Volume 3 / Issue 3 / DOI: 10.14744/ejmo.2019.48509
CASE REPORT

Her-2 Discordance Between Primer and Metastasis in Atypical Presentation of Metastatic Breast Cancer at the Time of Diagnosis: A Case Report

Irem Oner1 Erdem Sen1 Gonca Kara Gedik2 Burcu Keles3 Ceylan Ugurluoglu3 Ozlem Ata1
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1 Department of Medical Oncology, Selcuk University Faculty of Medicine, Konya, Turkey
2 Department of Nuclear Medicine, Selcuk University Faculty of Medicine, Konya, Turkey
3 Department of Pathology, Selcuk University Faculty of Medicine, Konya, Turkey
EJMO 2019, 3(3), 231–235; https://doi.org/10.14744/ejmo.2019.48509
Submitted: 9 April 2019 | Accepted: 1 July 2019 | Published: 27 July 2019
© 2019 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Breast cancer (BC) is the most common female cancer, the second most common cause of cancer death in women, and the main cause of death in women ages 40–59.The most common sites of BC metastases are liver, lung and bones. Metastases to the female genital tract from extragenital cancers are rare. Breasts and the gastrointestinal tract are the most common sites of the primary tumor.Several studies have carried out retrospective analyses comparing the ER, PR, and HER2 status of primary tumors and paired metastasis.We reported that HER2 discordance between primary and metastatic lesion in a 70-years old, postmenopausal woman who was diagnosed as invasive ductal carcinoma (IDC) with bone and endometrial metastases at the time of diagnosis.

Keywords
Breast cancer
Her2 discordance
metastasis
Conflict of interest
None declared.
References

Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics. CA Cancer J Clin 2009;59:225–49. [CrossRef]

2. Famoriyo A, Sawant S, BanWeld PJ. Abnormal uterine bleeding as a presentation of metastatic breast disease in a patient with advanced breast cancer on tamoxifen therapy. Arch Gynecol Obstet 2004;270:192–3. [CrossRef]

3. Piura B, Yanai-Inbar I, Rabinovich A, Zalmanov S, Goldstein J. Abnormal uterine bleeding as a presenting sign of metastases to the uterine corpus, cervix and vagina in a breast cancer patient on tamoxifen therapy. Eur J Obstet Gynecol Reprod Biol 1999;83:57–61. [CrossRef]

4. Karvouni E, Papakonstantinou K, Dimopoulou C, Kairi-Vassilatou E, Hasiakos D, Gennatas CG, Kondi-Paphiti A. Abnormal uterine bleeding as a presentation of metastatic breast disease in a patient with advanced breast cancer. Arch Gynecol Obstet 2009;279:199–201. [CrossRef]

5. N. B. Kumar, W. R. Hart, “Metastases to the uterine corpus from extragenital cancers. A clinicopathologic study of 63 cases,” Cancer, vol. 50, no. 10, pp. 2163–2169, 1982. [CrossRef]

6. M. T. Mazur, S. Hsueh, and D. J. Gersell, “Metastases to the female genital tract. Analysis of 325 cases,” Cancer, vol. 53, no. 9, pp. 1978–1984, 1984. [CrossRef]

7. Silverberg SG, Kurman RJ (1992) Atlas of Tumor Pathology: Tumors of the Uterine Corpus and Gestational Trophoblastic Disease, 3rd edn. Washington, 7 Armed Forces Institute of Pa-thology.

8. Mazur MT, Hsueh S, Gersell DJ. Metastases to the female genital tract. Analysis of 325 cases. Cancer 1984;53:1978–84.

9. Scopa CD, Aletra C, Lifschitz-Mercer B, Czernobilsky B: Metastases of breast carcinoma to the uterus. Report of two cases, one harboring a primary endometrioid carcinoma, with review of the literature. Gynecol Oncol 2005;96:543–7. [CrossRef]

10. Erkanli S, Kayaselcuk F, Kuscu E, Bolat F, Sakalli H, Haberal A. Lobular carcinoma of the breast metastatic to the uterus in a patient under adjuvant anastrazole therapy. Breast 2005;15:558–61. [CrossRef]

11. Acıkalin MF, Oner U, Tekin B, Yavuz E, Cengiz O. Metastasis from breast carcinoma to a tamoxifen related endometrial polyp. Gynecol Oncol 2005;97: 946–8. [CrossRef]

12. Di Bonito L, Patriarca S, Alberico S. Breast carcinomametastasizing to the uterus. Eur J Gynaecol Oncol 1985;6:211–7.

13. B. Piura, I. Yanai-Inbar, A. Rabinovich, S. Zalmanov, and J. Goldstein, “Abnormal uterine bleeding as a presenting sign of metastases to the uterine corpus, cervix and vagina in a breast cancer patient on tamoxifen therapy,” European Journal of Obstetrics Gynecology and Reproductive Biology, vol. 83, no. 1, pp. 57–61, 1999. [CrossRef]

14. L. Di Bonito, S. Patriarca, and S. Alberico, “Breast carcinoma metastasizing to the uterus,” European Journal of Gynaecologic Oncology, vol. 6, no. 3, pp. 211–217, 1985.

15. Ross JS, Slodkowska EA, Symmans WF, et al. The HER-2 receptor and breast cancer: ten years of targeted anti-HER-2 therapy and personalized medicine. Oncologist 2009;14:320–68.

16. Moasser MM. The oncogene HER2: its signaling and transforming functions and its role in human cancer pathogenesis. Oncogene 2007;26:6469–87.

17. Simmons C, Miller N, Geddie W, et al. Does confirmatory tumor biopsy alter the management of breast cancer patients with distant metastases? Ann Oncol 2009;20:1499–504.

18. Dieci MV, Barbieri E, Piacentini F, et al. Discordance in receptor status between primary and recurrent breast cancer has a prognostic impact: a single-institution analysis. Ann Oncol 2013;24:101–8. [CrossRef]

19. Santinelli A, Pisa E, Stramazzotti D, et al. HER-2 status discrepancy between primary breast cancer and metastatic sites.Impact on target therapy. Int J Cancer 2008;122:999–1004.

20. Lower EE, Glass E, Blau R, et al. HER-2/neu expression in primary and metastatic breast cancer. Breast Cancer Res Treat 2009;113:301–6. [CrossRef]

21. Amir E, Clemons M, Purdie CA, et al. Tissue confirmation of disease recurrence in breast cancer patients: pooled analysis of multi-centre, multi-disciplinary prospective studies. Cancer Treat Rev 2012;38:708–14. [CrossRef]

22. Lindstro¨m LS, Karlsson E, Wilking UM, et al. Clinically used breast cancer markers such as estrogen receptor, progesterone receptor, and human epidermal growth factor receptor2 are unstable throughout tumor progression. J Clin Oncol 2012;30:2601–8. [CrossRef]

23. B. B. O. Ustaalioglu, A. Bilici, M. Seker et al., “Metastasis of lobular breast carcinoma to the uterus in a patient under anastrozole therapy,”Onkologie, vol. 32,no. 7, pp.424–426,2009.

24. Niikura N, Liu J, Hayashi N, et al. Loss of human epidermal growth factor receptor 2 (HER2) expression in metastatic sites of HER2-overexpressing primary breast tumors. J Clin Oncol 2012;30:593–9. [CrossRef]

25. C. Liedtke, K. Broglio, S. Moulder, L. Hsu, S.-W. Kau,W. F. Symmans et al. Prognostic impact of discordance between triplereceptor measurements in primary and recurrent breast cancer. Ann Oncol 2009;20:12:1953-8. [CrossRef]

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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing