The Teaching Point

In patients with a history of breast cancer, particularly with a lobular subtype, a thorough radiological examination (ultrasound, CT, MRI followed by cystoscopy and mapping biopsy) of even the most unlikely secondary sites should be performed. Very subtle lower urinary tract symptoms may be the first signs of possible bladder metastasis.






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Metastatic Breast Cancer to the Bladder – case report and review of literature

Free full text article: Metastatic Breast Cancer to the Bladder – case report and review of literature

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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