A 64-year-old woman developed dysphagia 24 years after lumpectomy for breast cancer. CT showed thickening of the thoracic esophagus without distant metastases. Endoscopy showed mid-thoracic stenosis, and an endoscopic boring biopsy confirmed esophageal metastasis. PET demonstrated limited bone metastases. Chemotherapy was started after gastrostomy. Esophageal metastasis from breast cancer is rare and often difficult to diagnose because the lesions typically infiltrate the submucosa without mucosal involvement, making superficial biopsies insufficient. This case highlights the importance of considering metastatic disease in patients with a history of breast cancer who present with esophageal stenosis.
