Metastases to the female genital tract from invasive ductal carcinoma (IDC) of the breast are exceptionally rare and pose diagnostic and therapeutic challenges. We report the case of a 44-year-old woman with a history of right breast IDC who developed synchronous uterine and ovarian metastases four years after initial diagnosis. Clinical presentation included a firm breast mass and, later, heavy uterine bleeding. Imaging revealed a suspicious right breast lesion with axillary lymphadenopathy and diffuse bone metastases. Histopathology and immunohistochemistry confirmed metastatic breast carcinoma in the uterus and ovaries, showing strong hormone receptor positivity and GATA3 expression. Emergency hysterectomy was performed due to hemorrhagic complications. The patient is currently managed with endocrine therapy combined with CDK4/6 inhibitors, achieving disease control. This case emphasizes the importance of comprehensive pathological evaluation and a multidisciplinary approach in managing rare gynecological metastases of breast cancer, highlighting the role of targeted therapies in hormone receptor–positive metastatic disease.
Abbour et al. (Tue,) studied this question.