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Zhou H, Liu D, Chen L, Zhang Y, Zhao X, Ge Y, Liu M, Kong T. Metastasis to the bladder from primary breast cancer: A case report and literature review. Oncol Lett 2024; 27:249. [PMID: 38638844 PMCID: PMC11024766 DOI: 10.3892/ol.2024.14382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 01/11/2024] [Indexed: 04/20/2024] Open
Abstract
Breast cancer is the most prevalent malignant tumor affecting women and represents the leading cause of female cancer-related mortality worldwide. Although distant organ metastasis accounts for the majority of breast cancer-related deaths, reports on bladder metastasis are limited in the existing literature. The present study describes the case of a patient with bladder metastasis originating from breast cancer. In addition, the present study also provides a review of 54 cases of similar disease that have been documented in the currently available literature. The literature review aims to elucidate the clinicopathological characteristics and therapeutic approaches for such conditions. The median time from breast cancer diagnosis to bladder metastasis was found to be 5.6 years (range, 0-28 years). The origin of the bladder metastases was predominantly invasive ductal carcinoma (IDC) accounting for 52.3% of cases, followed by invasive lobular carcinoma, accounting for 40.9% of cases. The pathology in the primary tumor was the same as the pathology of the bladder metastases in all cases. There was an 88.9% concordance rate for estrogen receptor status, while the progesterone receptor status was 83.3% and the human epidermal growth factor receptor 2 expression status was 100%. The primary initial symptoms included urinary system manifestations, such as increased frequency, urgency, dysuria, urinary incontinence, nocturia and gross hematuria. For the cystoscopic examination, the predominant findings were bladder wall thickening or masses, along with ureteral orifice masses. Overall, the present study demonstrated that the occurrence of bladder metastasis often follows the metastasis of other organs, with IDC being the most prevalent subtype. The pathological characteristics between the primary tumor and bladder metastasis exhibit a high degree of concordance.
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Affiliation(s)
- Hanli Zhou
- Department of Oncology, Cancer Hospital of Henan University, The Third People's Hospital of Zhengzhou, Zhengzhou, Henan 450000, P.R. China
| | - Danna Liu
- Department of Pharmacy, Cancer Hospital of Henan University, The Third People's Hospital of Zhengzhou, Zhengzhou, Henan 450000, P.R. China
| | - Lu Chen
- Department of Oncology, Cancer Hospital of Henan University, The Third People's Hospital of Zhengzhou, Zhengzhou, Henan 450000, P.R. China
| | - Yujie Zhang
- Department of Oncology, Cancer Hospital of Henan University, The Third People's Hospital of Zhengzhou, Zhengzhou, Henan 450000, P.R. China
| | - Xiaoli Zhao
- Department of Oncology, Cancer Hospital of Henan University, The Third People's Hospital of Zhengzhou, Zhengzhou, Henan 450000, P.R. China
| | - Yongchao Ge
- Department of Urology, Cancer Hospital of Henan University, The Third People's Hospital of Zhengzhou, Zhengzhou, Henan 450000, P.R. China
| | - Mengmeng Liu
- Department of Pathology, Cancer Hospital of Henan University, The Third People's Hospital of Zhengzhou, Zhengzhou, Henan 450000, P.R. China
| | - Tiandong Kong
- Department of Oncology, Cancer Hospital of Henan University, The Third People's Hospital of Zhengzhou, Zhengzhou, Henan 450000, P.R. China
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Malinaric R, Balzarini F, Granelli G, Ferrari A, Trani G, Ambrosini F, Mantica G, Panarello D, De Rose AF, Terrone C. From women to women—hematuria during therapy for metastatic breast cancer, what to suspect and when to be alarmed; Bladder metastasis from breast cancer—our experience and a systematic literature review. Front Oncol 2022; 12:976947. [PMID: 36248976 PMCID: PMC9557997 DOI: 10.3389/fonc.2022.976947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
Breast cancer is one of the most important causes of premature mortality in women worldwide. Around 12% of breast cancer patients will develop metastatic disease, a stage associated with poor prognosis, and only 26% of patients are likely to survive for at least 5 years after being diagnosed. Although the most common sites where breast cancer tends to spread are bones, lungs, brain, and liver, it is important that physicians consider other less frequent organs and viscera, like the bladder, as a target destination. In this article we report our experience with this rare form of metastases and a systematic literature review. We analyzed case reports, case series, and review articles present in PubMED/MEDLINE up to March 2022. We excluded the nonrelevant articles, editorials, letters to the editor, and articles written in other languages. We identified a total of 302 articles, with 200 articles being removed before screening; therefore, the total number of abstracts reviewed was 102. Fifty-five articles were excluded before full text review because they did not meet the inclusion criteria, and one article was not retrievable. Therefore, we included a total of 45 articles in this review. The intention of this review is to highlight the importance of the early detection of bladder metastases and to facilitate the diagnostic process for the responsible physician. The most common signs and symptoms and breast cancer subtype associated with bladder metastases, as well as overall survival after their detection, were all assessed. Bladder metastases from metastatic breast cancer are prevalent in the invasive, lobular breast cancer subtype; most patients present with hematuria (39.5%) and the relative 5-year survival rate is 2%. The main limitations of this review are the low number of cases reported in the literature, clinical and pathological differences between the individual cases, and absence of the control group. This study was not funded.
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Affiliation(s)
- Rafaela Malinaric
- Department of Urology, L'Istituto di ricovero e cura a carattere scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
- *Correspondence: Rafaela Malinaric,
| | - Federica Balzarini
- Department of Urology, L'Istituto di ricovero e cura a carattere scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Giorgia Granelli
- Department of Urology, L'Istituto di ricovero e cura a carattere scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Arianna Ferrari
- Department of Urology, L'Istituto di ricovero e cura a carattere scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Giorgia Trani
- Department of Urology, L'Istituto di ricovero e cura a carattere scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Francesca Ambrosini
- Department of Urology, L'Istituto di ricovero e cura a carattere scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Guglielmo Mantica
- Department of Urology, L'Istituto di ricovero e cura a carattere scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy
| | - Daniele Panarello
- Department of Urology, L'Istituto di ricovero e cura a carattere scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy
| | - Aldo Franco De Rose
- Department of Urology, L'Istituto di ricovero e cura a carattere scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy
| | - Carlo Terrone
- Department of Urology, L'Istituto di ricovero e cura a carattere scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
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3
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Kase AM, Menke D, Tan W. Breast cancer metastasis to the bladder: a literature review. BMJ Case Rep 2018; 2018:bcr-2017-222031. [PMID: 29954760 DOI: 10.1136/bcr-2017-222031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Given the prevalence of breast cancer and the mortality associated with metastatic disease, it is imperative for physicians to not only be aware of common sites but also of rare metastatic destinations such as the bladder. A postmenopausal woman with a medical history of stage 2 invasive ductal carcinoma, oestrogen receptor/progesterone receptor positive and human epidermal growth factor receptor 2 negative, in remission for 9 years, presented to her primary care physician with concerns of increased urinary urgency, frequency and incontinence. The patient underwent cystoscopy with biopsy of an area of granulation tissue. Biopsy revealed adenocarcinoma consistent with breast primary. The common sites of metastases from breast cancer are lung, bone and liver. This case is unique where breast cancer was found to metastasise to the bladder. It is important for physicians to consider further investigation when a breast cancer survivor develops urinary symptoms even without haematuria.
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Affiliation(s)
- Adam M Kase
- Department of Internal Medicine, Mayo Clinic's Campus in Florida, Jacksonville, Florida, USA
| | - David Menke
- Department of Pathology, Mayo Clinic's Campus in Florida, Jacksonville, Florida, USA
| | - Winston Tan
- Department of Hematology, Mayo Clinic's Campus in Florida, Jacksonville, Florida, USA.,Department of Oncology, Mayo Clinic's Campus in Florida, Jacksonville, Florida, USA
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4
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Gatti G, Zurrida S, Gilardi D, Bassani G, dos Santos GR, Luini A. Urinary Bladder Metastases from Breast Carcinoma: Review of the Literature Starting from a Clinical Case. TUMORI JOURNAL 2018; 91:283-6. [PMID: 16206659 DOI: 10.1177/030089160509100317] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bladder metastases from solid tumors are rare. Breast carcinoma cells seldom spread to the urinary bladder. We report the case of a patient with invasive breast carcinoma who developed a breast recurrence followed by bone and urinary bladder metastases. Starting from this clinical case we review the available literature on this issue. Only few cases of urinary bladder metastases from primary breast cancer have been reported, although the case reports have increased in recent years. Patients with breast cancer presenting with urinary symptoms should be examined for possible bladder metastases.
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Affiliation(s)
- Giovanna Gatti
- Division of Breast Surgery, European Institute of Oncology, Milan, Italy.
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5
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Luczyńska E, Pawlik T, Chwalibóg A, Anioł J, Ryś J. Metastatic Breast Cancer to the Bladder case report and review of literature. J Radiol Case Rep 2010; 4:19-26. [PMID: 22470730 DOI: 10.3941/jrcr.v4i5.395] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The main cause of mortality among patients with breast cancer is the metastatic spread of the primary tumour. The urinary bladder is considered as an unusual site for breast cancer metastasis. A patient has presented with right breast tumour and qualified for surgical treatment. After removal of the mass, an intra-operative and final pathology evaluation indicated breast invasive lobular carcinoma. Adjuvant chemotherapy was given. Years later, an increase of serum CA15-3 tumour marker level was noted and physical examination revealed a lump at the mastectomy scar. A follow-up abdominal ultrasound scan demonstrated thickening of the urinary bladder wall segment, confirmed later by CT scan. A transurethral resection of bladder was performed, reaffirming a neoplastic mass, with histological assessment revealing invasive breast carcinoma. Palliative chemotherapy was given and another follow-up ultrasound scans were unremarkable. The patient is alive today.
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Affiliation(s)
- Elżbieta Luczyńska
- Department of Diagnostic Imaging, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Cracow, Poland
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6
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Zagha RM, Hamawy KJ. Solitary breast cancer metastasis to the bladder: An unusual occurrence. Urol Oncol 2007; 25:236-9. [PMID: 17483021 DOI: 10.1016/j.urolonc.2006.05.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2006] [Accepted: 05/09/2006] [Indexed: 10/23/2022]
Abstract
Breast carcinoma is the most common nondermatologic cancer diagnosis in women. Common metastatic sites include lymph nodes, lung, liver, and bone. Metastases to the bladder are exceedingly rare. To date, there are a total of 31 reports of patients diagnosed with metastatic breast cancer to the bladder while living. Only 5 of these patients were reported to have no other site of metastasis, other than axillary nodes at breast surgery. We present the sixth reported case of metastatic breast carcinoma solely to the bladder in a living patient.
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Affiliation(s)
- Ralph M Zagha
- Department of Urology, Lahey Clinic, Burlington, MA 01805, USA
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7
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Forster J, Agrawal V, Anathhanam AJ, Spencer N, Biyani CS. Breast carcinoma metastasizing to the urinary bladder presenting as bilateral hydronephrosis treated with ureteral stenting and chemotherapy. Urol Oncol 2006; 24:33-5. [PMID: 16414490 DOI: 10.1016/j.urolonc.2005.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2005] [Revised: 07/21/2005] [Accepted: 07/22/2005] [Indexed: 11/27/2022]
Abstract
We describe a case of metastatic breast carcinoma involving the urinary bladder and causing bilateral hydronephrosis. Treatment consisted of bilateral renal decompression followed by chemoradiotherapy. The pertinent literature is reviewed.
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Affiliation(s)
- James Forster
- Department of Urology, Pinderfields General Hospital, Mid Yorkshire Hospitals NHS Trust, West Yorkshire WF1 4DG, United Kingdom
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8
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Soon PSH, Lynch W, Schwartz P. Breast cancer presenting initially with urinary incontinence: a case of bladder metastasis from breast cancer. Breast 2004; 13:69-71. [PMID: 14759720 DOI: 10.1016/j.breast.2003.09.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2003] [Revised: 08/14/2003] [Accepted: 09/10/2003] [Indexed: 11/16/2022] Open
Abstract
Bladder metastasis from breast cancer is rare. Patients with breast cancer, in particular patients with a lobular carcinoma subtype, who present with urinary symptoms including incontinence, hematuria, dysuria, and frequency should have the possibility of bladder metastases kept in mind and investigated with cystoscopy and imaging as necessary.
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Affiliation(s)
- P S H Soon
- Division of Surgery, Breast/Endocrine Surgery Unit, St George Hospital, Griffith House, Gray St, Kogarah, NSW 2217, Australia.
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9
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Feldman PA, Madeb R, Naroditsky I, Halachmi S, Nativ O. Metastatic breast cancer to the bladder: a diagnostic challenge and review of the literature. Urology 2002; 59:138. [PMID: 11796308 DOI: 10.1016/s0090-4295(01)01489-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Nineteen cases of breast cancer metastatic to the bladder and diagnosed in living patients have been identified in the English literature. Most patients were symptomatic with evidence of disseminated disease at the time of diagnosis. Metastasis usually occurred many years after diagnosis, and the prognosis was poor. The definitive modality for diagnosis in all cases was cystoscopy, which demonstrated an abnormal lesion in the bladder wall that was confirmed on biopsy. In our study, we discuss the case of a patient with breast cancer metastatic to the bladder despite a normal cystoscopic evaluation.
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Affiliation(s)
- Paul A Feldman
- Department of Urology, Bnai Zion Medical Center, Haifa, Israel
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10
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Schneidau T, Stroumbakis N, Choudhury M, Eshgi M, Mallouh C. Metastatic breast cancer to the bladder: a case report. Int Urol Nephrol 1995; 27:297-300. [PMID: 7591593 DOI: 10.1007/bf02564765] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- T Schneidau
- Department of Urology, New York Medical College, Valhalla, USA
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