Breast and Axillary Lymph Node Metastasis from Ovarian Cancer: A Case Report

BACKGROUND: Breast metastasis (BM) is extremely rare. Ovarian cancer accounts for approximately 0.03% to 0.6% of all BMs. BM diagnosis is challenging and the prognosis very poor. The treatment is multidisciplinary and strictly related to multiple clinical and biological factors.
CASE REPORT: A 70-year-old non-smoking Caucasian woman was hospitalized for a 4-month history of abdominal pain, anorexia, and weight loss of 10 kg. During the clinical examination, we found multiple axillary lymph nodes and a painless tumor lesion in the superior internal quadrant of the right breast. Whole body CT-scan and ¹⁸F-fluorodeoxyglucose PET scan documented a right ovarian tumor associated with multiple metastases, a hypermetabolic lesion of the right breast, and multiple axillary lymphadenopathies that were confirmed by breast ultrasonography. The percutaneous biopsy of both the right axillary lymph node and breast tumor showed a metastasis from a high-grade serous papillary ovarian adenocarcinoma. Considering the tumor aggressiveness and the lack of BRCA1 and BRCA2 mutations, we started systemic chemotherapy with a 3-week carboplatin/paclitaxel regimen combined with bevacizumab, which quickly improved the patient’s symptoms and induced a biological tumor response.
CONCLUSIONS: This case reports a synchronous breast metastasis from an ovarian cancer and highlights this uncommon entity, which is very difficult to diagnose and treat. A differential diagnosis from a primary breast cancer should be considered as the treatment and prognosis of these 2 tumors are different.

Keywords: Breast, Lymphatic Metastasis, Ovarian Neoplasms