Breast Cancer with Delayed Metastasis Only to Contralateral Regional Lymph Nodes: A Case Report and Review of the Literature

Abstract

Delayed metastasis only to contralateral regional lymph nodes of a unilateral breast cancer has been considered as a systemic metastasis or a regional metastasis from contralateral primary occult breast cancer. This staging uncertainty has complicated for clinicians to choose treatment regimens for it. We report a case of a 52-year-old woman with metastasis only to contralateral regional lymph nodes 20 months after prior treatment of a unilateral breast cancer. She was treated with lymph node dissection, radiation therapy, chemotherapy, and hormonal therapy. Now 13 months after second surgery, the patient is alive without any evidence of breast cancer recurrence or metastasis. We suggest that solitary contralateral regional metastasis, especially post-breast-conserving surgery followed by radiation therapy, should be considered not only as hematogenous spread but also lymphatic spread. Although controversial, lymph node dissection for the delayed metastasis of breast cancer only to the contralateral regional lymph nodes can be of curative intent.