Metastatic breast cancer presenting with dyspeptic symptoms - a case report

Sep 23, 2026

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Breast cancer is among the most frequently diagnosed malignancies worldwide, yet gastrointestinal metastasis is uncommon. This case report describes the synchronous diagnosis of a 78-year-old woman’s primary breast cancer and gastric metastasis. After nonspecific dyspeptic symptoms initially improved with proton pump inhibitor therapy, gastric biopsy confirmed metastatic invasive lobular carcinoma and imaging later showed diffuse bony metastases. The report emphasizes diagnostic complexity and imaging limitations, and supports considering breast cancer metastasis in the differential diagnosis for non-specific GI complaints.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Background

Introduction

Knowledge gap

Aim

Case presentation

Patient history and presenting complaint

Diagnostic findings

Management and follow-up

Conclusions

Bekai and Stirling Journal of Medical Case Reports (2026) 20:148 [https://doi.org/10.1186/s13256-026-05864-9](https://doi.org/10.1186/s13256-026-05864-9) Journal of Medical Case Reports CASE REPORT Open Access Metastatic breast cancer presenting with dyspeptic symptoms: a case report Chantae Bekai1* and Michael Stirling2 Abstract Background Breast cancer is among the most commonly diagnosed malignancies worldwide. While distant metastases typically involve the bone, lung, liver, and brain, metastasis to the gastrointestinal tract is uncommon and occurs disproportionately in invasive lobular carcinoma (ILC) . The clinical presentation is often nonspecific, which can delay diagnosis. This case presents the synchronous diagnosis of both primary breast cancer and gastric metastasis. Case presentation A 78-year-old woman presented with chronic belching, dyspepsia, and intermittent melena. Initial treatment and improvement with proton pump inhibitor therapy, suggested a primary gastrointestinal disorder. However, gastric biopsy confirmed metastatic invasive lobular carcinoma, and subsequent imaging revealed diffuse bony metastases. Conclusions This case highlights the synchronous diagnosis of gastric metastases originating from invasive lobular carcinoma with its associated diagnostic complexities and the limitations of traditional imaging modalities in detecting such metastases. Early recognition and accurate diagnosis are crucial for guiding appropriate treatment and improving patient outcomes. Therefore, we present a case that suggests considering breast cancer metastasis in the differential diagnosis for patients presenting with nonspecific gastrointestinal symptoms, even in the absence of breast-related complaints, is a reasonable clinical approach. Keywords Invasive lobular carcinoma (ILC), Invasive ductal carcinoma (IDC), Breast cancer, Gastric metastases Background Introduction Breast carcinoma is the second most diagnosed cancer in Canada and the leading cause of cancer-related death among women worldwide [1]. Advancements in systemic treatments, including targeted therapy, chemotherapy, and endocrine therapy, have improved the overall survival rates of patients with breast cancer; however, these therapies have not significantly affected the prognosis of *Correspondence: Chantae Bekai [chantae.bekai@medportal.ca](chantae.bekai@medportal.ca) 1 Division of General Surgery, Department of Surgery, McMaster University, St. Catharines, ON, Canada 2 Division of General Surgery, Department of Surgery, NOSM University, Sudbury, ON, Canada patients with distant metastasis [2]. Breast cancer can be invasive or noninvasive, according to its histological relation to the basement membrane [3]. Invasive carcinoma can be further divided into lobular, ductal, and mixed histologic types. Lobular carcinoma accounts for 10–15% of invasive breast cancer cases. Furthermore, even within the lobular carcinoma group, metastases to the gastrointestinal (GI) tract is a rare manifestation [4]. Invasive ductal carcinoma (IDC) tends to metastasize to the lungs, liver, bones, soft tissue, brain, and adrenal glands, whereas the GI system, gynecologic organs, and peritoneum‒retroperitoneum metastases are unique to invasive lobular carcinoma (ILC) [5]. The mechanism by which ILCs preferentially metastasize to these locations is not fully understood, but several authors have hypothesized that it could be related to a particular tropism for lobular cells in certain anatomical areas, suggesting that © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed mate

FAQs

Why can dyspeptic symptoms delay diagnosis in this case?

The presentation is often nonspecific, which can lead clinicians to initially treat a primary gastrointestinal disorder rather than consider metastatic disease. In this report, improvement with proton pump inhibitors initially suggested a GI cause.

What confirmed the diagnosis of gastric metastasis?

Gastric biopsy confirmed metastatic invasive lobular carcinoma. Subsequent imaging revealed diffuse bony metastases.

What clinical takeaway does the case report emphasize?

Early recognition and accurate diagnosis are crucial, and breast cancer metastasis should be considered in the differential diagnosis for patients with nonspecific gastrointestinal symptoms even without breast-related complaints.

Sep 23, 2026

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