Contralateral axillary metastasis: a diagnostic and therapeutic clinical dilemma

BMJ Case Rep. 2021 Feb 9;14(2):e240036. doi: 10.1136/bcr-2020-240036.

Abstract

We report a 61-year-old woman with primary right breast cancer and metastatic lymphadenopathy in the contralateral axilla. This case represents a clinical dilemma because primary breast cancer, occult contralateral breast cancer and extra-mammary primary lesion can all be the source of the contralateral axillary metastasis. The patient underwent bilateral modified radical mastectomy. Immunohistochemistry revealed that the right breast was positive for estrogen receptor (ER) and progesterone receptor (PR), but negative for human epidermal growth factor receptor-2 (HER2). In contrast, the right and left axillary lymph nodes were positive for ER, but negative for PR and HER2. There was no evidence of occult primary cancers or extra-mammary tumours.

Keywords: breast cancer; breast surgery; surgical oncology.

Publication types

  • Case Reports

MeSH terms

  • Axilla / pathology*
  • Biomarkers, Tumor / analysis
  • Breast Neoplasms / metabolism*
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • ErbB Receptors / metabolism
  • Female
  • Humans
  • Lymphatic Metastasis / pathology*
  • Mastectomy, Modified Radical
  • Middle Aged
  • Receptors, Estrogen / metabolism
  • Receptors, Progesterone / metabolism

Substances

  • Biomarkers, Tumor
  • Receptors, Estrogen
  • Receptors, Progesterone
  • ErbB Receptors