Metastatic spread of
breast carcinoma to the colon and rectum is rare. We report the case of a patient treated for lobular
breast carcinoma presenting 17 years later with metastatic
breast cancer of the colon. A 63-year-old lady with a past history of right-sided invasive
lobular carcinoma of the breast presented with persistent diarrhoea. Colonoscopy with biopsies revealed a benign-looking
stricture at the rectosigmoid junction. A CT scan of the abdomen and pelvis revealed a benign-looking
stricture in keeping with a probable diverticular
stricture. A Hartmann procedure was performed and histology revealed a metastatic
lobular carcinoma with oestrogen and
progesterone receptor-positive status. Treatment was commenced with
letrozole and the patient remains well under clinical surveillance. In a patient with a history of
breast carcinoma who presents with gastrointestinal symptoms the possibility of gastrointestinal tract spread should always be considered. Endoscopic diagnosis may be misleading with pathological diagnosis only being made following surgical resection. A history of
breast carcinoma must be declared to the histopathologist following surgical resection so that an accurate diagnosis is made and appropriate treatment is commenced.