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Case Reports
. 2022 Nov 24;15(11):e251721.
doi: 10.1136/bcr-2022-251721.

Metastatic spread of serous ovarian carcinoma to the bilateral breasts: a rare presentation

Arif Musa  1 , Michael Joiner  1 , Stephen Dzul  1 , Steven Raymond Miller  2
Affiliations
Case Reports

Metastatic spread of serous ovarian carcinoma to the bilateral breasts: a rare presentation

Arif Musa et al. BMJ Case Rep. .

Abstract

A woman presented with a mass in her right breast. She had previously been treated with carboplatin, paclitaxel and bevacizumab for serous ovarian carcinoma diagnosed 5 years previously and was currently on maintenance olaparib. A right breast mammogram demonstrated periareolar skin thickening and the physical examination revealed an erythematous, non-blanching cutaneous lesion. A punch biopsy revealed high-grade serous carcinoma of ovarian origin, positive for PAX-8, WT-1 and p53. Positron emission tomogram-CT scan showed diffusely increased fluorodeoxyglucose uptake in the right breast. She was treated with external beam radiation therapy to the right breast and regional lymphatics and received 5200 cGy in 20 fractions to the right breast and supraclavicular region with good response. Two weeks after completing radiation therapy, she presented with a new lesion inferior to her left areola, concerning for metastasis to the contralateral breast. Subsequent biopsy of the left breast identified metastatic serous ovarian carcinoma for which she received an additional 5200 cGy in 20 fractions to the breast.

Keywords: Breast cancer; Gynecological cancer; Radiotherapy.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Left and right breasts at time of radiation planning.
Figure 2
Figure 2
Axial PET scan image demonstrating increased FDG uptake in the right breast. FDG, fluorodeoxyglucose; PET, positron emission tomogram.
Figure 3
Figure 3
Representative CT simulation axial images displaying right and left breast radiation fields.
Figure 4
Figure 4
Radiation treatment plan showing predicted dose distribution from bilateral breast irradiation.
See this image and copyright information in PMC

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