A Case of Breast Cancer with Contralateral Axillary Lymph Node Metastasis after Breast Conserving Surgery with Axillary Lymph Node Dissection

Abstract

We report a case of breast cancer with contralateral axillary lymph node metastasis from ipsilateral breast cancer after breast conserving surgery. The patient was a 57-year-old woman who had undergone right breast conserving surgery and axillary lymph node dissection for right breast cancer at the age of 46. She was diagnosed with ipsilateral breast cancer and contralateral axillary lymph node metastasis 11 years after the operation. Both of them were histologically consistent, but were different from the primary lesion at the age of 46. A preoperative lymphoscintigraphy revealed lymphatic drainage to the contralateral axillary node. The results meant that the contralateral axillary lymph node could be regarded as regional lymph node. Therefore, we diagnosed the ipsilateral breast cancer as a new primary breast cancer without distant metastasis and performed multidisciplinary treatment including surgical resection for a radical cure. Since contralateral axillary lymph node metastasis is usually distant metastasis, surgical resection is not recommended except for limited cases. In the case of ipsilateral breast cancer after breast conserving surgery and axillary lymph node dissection, contralateral axillary lymph node metastasis might be regarded as regional lymph node metastasis, and we should consider to perform multidisciplinary treatment including surgical resection for a radical cure.