title: Unique presentations of invasive lobular breast cancer: a case series.
abstract: BACKGROUND
  Breast carcinoma is the most common malignancy in women. Unlike IDC, which typically metastasizes to the lung, liver or bone, ILC has been found to metastasize to GI tract, peritoneum and retroperitoneum. Nonspecific symptomology may be considered secondary to other diseases and this can delay the definite diagnosis and treatment of metastatic disease. Knowledge of the pattern of disease spread is essential for accurate diagnosis and early initiation of systemic treatment, thus avoiding unnecessary interventions. We are reporting three unique cases of metastatic ILC presenting with wide range of symptoms.
  
  
  METHODS
  Case A: 69-year-old female presented with recurrent jaundice. Case B: 77-year-old female with the past medical history of right breast ILC seven years ago status post right radical mastectomy with chemotherapy, presented with anemia. Case C: 56-year-old female presented with bright red blood per rectum.
  
  
  CONCLUSIONS
  A high level of suspicion is needed for metastatic breast cancer in patients with history of ILC, regardless of disease free interval. Since it frequently metastasizes to unusual sites and presents with a wide spectrum of symptoms.
authors.affiliation: Department of Internal Medicine, Baystate Medical Center (Tufts University School of Medicine), Springfield, MA, USA;
authors.forename: Muhammad Tariq
authors.initials: MT
authors.lastname: Shakoor
authors.affiliation: Department of Pulmonary and Critical Care, University of Arkansas for Medical Sciences, Little Rock, AR, USA;
authors.forename: Samia
authors.initials: S
authors.lastname: Ayub
authors.affiliation: Department of Hematology/Oncology, St Mary Mercy Hospital, Livonia, MI, USA;
authors.forename: Ramesh
authors.initials: R
authors.lastname: Mohindra
authors.affiliation: Medical Student, Fatima Jinnah Medical College, Lahore, Pakistan;
authors.forename: Zunaira
authors.initials: Z
authors.lastname: Ayub
authors.affiliation: Medical Student, Nishter Medical College, Multan, Pakistan.
authors.forename: Abdul
authors.initials: A
authors.lastname: Ahad
keywords: Breast Cancer; metastasis; Invasive Ductal Carcinoma (IDC); Invasive lobular carcinoma (ILC)