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A brief overview of cases of breast cancer metastasis to the uterus. A clinical case

https://doi.org/10.33667/2078-5631-2025-26-49-55

Abstract

Breast cancer (BC) can metastasize to many organs, but metastases to the uterus are rare. Breast cancer metastases in the uterus can appear synchronously and metachronously, be asymptomatic or in the form of abnormal vaginal bleeding. Treatment of uterine metastases usually includes total abdominal hysterectomy with bilateral salpingo-oophorectomy in combination with chemotherapy. The long-term prognosis of this course is unclear, but the outcome is mostly unfavorable. This article analyzes 60 patients, published in the literature for the period from 2010 to July 2024. according to nine variables, including: age; morphology of breast cancer; treatment for breast cancer; spread of metastases in the uterus; treatment; out-of-phase distant metastases; survival. The article presents a clinical case of a 53-year-old patient who was diagnosed with metastasis of invasive ductal breast carcinoma into the uterine body. The patient underwent cytoreductive surgery to extirpate the uterus with appendages, followed by hormone therapy with aromatase inhibitors (letrazole).

About the Authors

G. G. Khakimova
Department of Oncology, Pediatric Oncology and Palliative Care of Tashkent State Medical University; Tashkent City Branch of the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology; Department of Oncology, Radiotherapy and Reconstructive Surgery of the N. V. Sklifosovsky Institute of Clinical Medicine at I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Uzbekistan

Khakimova Gulnoz G., PhD Med, associate professor at Dept of Children’s Oncology, head of the Chemotherapy Dept, Assistant of the Dept of Oncology, Radiotherapy and Reconstructive Surgery

Tashkent

Moscow



A. N. Rakhmonov
Department of Oncology, Pediatric Oncology and Palliative Care of Tashkent State Medical University
Uzbekistan

Rakhmonov Akbar N., student of paediatrics

Tashkent



S. I. Erkinova
Department of Oncology, Pediatric Oncology and Palliative Care of Tashkent State Medical University
Uzbekistan

Erkinova Shirin I., medical student

Tashkent



S. G. Khakimov
Department of Oncology, Pediatric Oncology and Palliative Care of Tashkent State Medical University; P. A. Herzen Moscow State Medical Research Institute – Branch of the National Medical Research Center of Radiology
Russian Federation

Khakimova Shakhnoz G., PhD Med, associate professor at Dept of Paediatric Oncology, trainee of the Dept of Reconstructive Plastic Surgery of Breast and Skin

Tashkent

Moscow



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For citations:


Khakimova G.G., Rakhmonov A.N., Erkinova S.I., Khakimov S.G. A brief overview of cases of breast cancer metastasis to the uterus. A clinical case. Medical alphabet. 2025;(26):49‑55. (In Russ.) https://doi.org/10.33667/2078-5631-2025-26-49-55

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