Metastasis of cervical cancer to breast: A case report and review of literature

Abstract

Metastasis to the breast from an extra-mammary malignancy has been documented in literature, however cervical cancer metastasis to the breast is very rare. Thirty-eight cases of metastatic deposit to the breast from cervical cancer have been reported in literature. Though most patients present with a breast lump, it is very difficult to clinically distinguish a primary breast malignancy from a metastatic deposit. Histopathology of the tissue, aided with immune-histochemical staining pattern provides a definitive diagnosis. Our patient, a 51-year old woman presented with breast lump and history of post-menopausal bleeding. Upon further workup, the patient was diagnosed with cervical cancer. The mammogram and ultrasound of the breast showed multiple lumps within the breast. Histopathology of the breast mass showed metastatic deposit in the breast from cervical cancer. The patient was treated with radiation therapy to the cervix along with concurrent chemotherapy for local control of pain. After completion of local treatment, she started systemic chemotherapy, however she developed health-care associated pneumonia and subdural hematoma leading to deterioration in her performance status. The patient opted for hospice care and died 2 months later. In this report, we will review the presentation of the 38 cases reported in literature and the imaging and histopathologic findings of metastatic deposits to the breast.

Imaging Findings of Breast Metastasis from Squamous Cell Carcinoma of the Cervix: A Case Report

“…and lymphatic spreading routes. There are some common radiological features according to their routes (1,4,7). Typical image findings of lymphatic metastasis are skin thickening, obliteration of subcutaneous fat layer, and a thick trabecular pattern, along with dense and irregular stroma, which finding can be seen by ultrasonography and mammography (1,4).…”

“…Therefore, the breast lesion was upgraded to BI-RADS category 4 (suspicious). These rapid growing tumors with cystic component are known to undergo intratumoral hemorrhagic change or necrosis with poor differentiation (1,4).…”

“…Metastasis of cervical cancer to the breast is quite uncommon (1)(2)(3)(4)(5)(6)(7). Differentiating metastatic breast cancers from benign breast tumors or primary breast cancers is difficult.…”

“…Breast metastasis may occur years after a known primary cancer or it might be the first manifestation site of malignant disease (2,8). However, it is important to diagnosis metastatic breast cancer from primary breast cancer, due to the treatment of patient is totally different (1,2,8,9). Therefore, the possibility of metastasis to the breast should be considered in patients with primary malignancy in other organs.…”

“…Therefore, the possibility of metastasis to the breast should be considered in patients with primary malignancy in other organs. Histopathologic diagnosis should be performed (1).…”