442 Cervical metastasis of breast carcinoma: a rare presentation

Introduction/Background Breast cancer metastases usually occur in bone, lung or liver. Metastasis in the female genital tractus is an uncommon event. We report 2 cases of metastasis of breast carcinoma involving the uterine cervix. Methodology In this two reports, we present 2 women who were previously treated for breast cancer and relapsed with cervical metastases. Results A 49-year-old female initially was diagnosed and treated for an invasive hormone positive (HR) HER2 neu negatif lobular carcinoma of the right breast (T4bN1M0). She was treated with radical mastectomy and lymph-node dissection. Surgery was followed by sequential chemotherapy, radiation therapy and Tamoxifen. Two years post-operatively, an increase of tumor biomarker CA15–3 was observed. A PET-CT revealed a hypermetabolic lesion of the uterine cervix. The biopsy revealed a carcinoma immunohistochemically compatible with initially diagnosed breast carcinoma HR positive. Pelvic MRI revealed two lesions of the lateral vaginal fornix in addition to hepatic, ovarian, lymph-node and peritoneal metastasis. She died of acute hepatic failure before starting chemotherapy. Case 2: A 55-year-old female was diagnosed with invasive ductal cell luminal B breast carcinoma (T2N0M0). Radical surgery was performed, followed by 4 courses of chemotherapy and Letrozole for five years. Eleven years later, a recurrent pelvic pain and discomfort revealed a cervical recurrence of the ductal carcinoma. Examination showed an enlarged and indurated uterine cervix. Body-scan showed hepatic, peritoneal and ovarian metastasis. Biopsy concluded to an ectocervical tumor cells proliferation of mammary origin. Immunohistochemically, staining was positive for GATA3 and hormone receptors, negative for P16 and HER2neu receptors. First-line therapy consisted of Ribociclib and Letrozole. Conclusion Despite the rarity of the presentation, patients with breast cancer may should benefit from a thorough gynecologic screening for metastasis during follow-up. Disclosures We have no conflicts of interest to disclose. All authors declare that they have no conflicts of interest.