الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 117 |  |  |
| | | from | 117 | | |
Abstract
Abdominopelvic metastases from breast cancer present a therapeutic difficulty. The literature is deficient in data, and the provided data are scattered. Many unusual sites and patterns that are often overlooked which results in delay in the proper diagnosis, case deterioration and bad outcome. Other findings are related to chemotherapy and hormonal therapy.
The aim of the study was to investigate the utility of CECT in detecting abdominopelvic metastases in patients with primary breast cancer for disease staging (denovo metastasis) in newly diagnosed cases and during disease follow up (relapsed metastasis) and to use CECT in detecting systemic therapy induced changes in breast cancer patients.
The current study was carried out on a purposive sample of biopsy-proven breast cancer patients, who were referred to multiple institutions for staging purpose and/or on annual follow up. These namely: the Alexandria University hospitals, Medical Research Institute and private sector of Radio-diagnosis departments.
Retrospective chart reviewing was conducted where all patients’ clinical files (paper files or electronic radiological data base) of patients with advanced breast cancer who underwent CT at the selected settings during 36-month period (January 2018 to December 2020) was reviewed retrospectively.
A total of 412 complete medical records of breast cancer patients were reviewed. Almost 313 female patients showed negative or incidental findings and 99 female patients showed positive radiological findings on CECT either as abdominopelvic metastasis and/or toxicity related to systemic therapy of breast cancer. Those 99 patients achieved the inclusion criteria for the current study.
The age of the 99 patients included in the current study ranged from 30 to 76 years, with a mean age of 51.80 ± 11.26 years and a median of 51 years. The highest percentage (32.3%) of female patients was among the age group between 40 to 50 years.
Among the 99 patients; family history of breast cancer was positive in 24 patients (24.2%) and only 4 patients were nulliparous (4%). More than half [53 (53.5%)] of the studied females were post-menopausal. Twenty-four (24.2%) of them had comorbid conditions either: diabetes, hypertension, hypothyroidism or liver cirrhosis. Eighty-seven patients (87.9%) presented by breast lump as their first complaint. Mammogram revealed breast cancer in most [93 cases (93.9%)] of the studied subjects.
Invasive ductal carcinoma (IDC) was the most encountered histopathological type of breast cancer in the studied subjects [82 patients (82.8%)] and luminal A was the most common immunohistochemical subtype [57 patients (57.6%)].
The current study revealed 88 patients (88.9%) showing positive radiological evidence for abdominopelvic metastasis on CECT. Among them, 26 patients (29.5%) were denovo metastatic, while 62 patients (70.5%) were relapsed metastatic. In the relapsed cases, average time lapse from the diagnosis of breast cancer till the detection of metastasis was ≤2 years in 19 cases (30.6%), 2-5 years in 25 cases (40.3%) and >5 years in 18 cases (29%).