![]() The intraoperative axillary sentinel lymph node (SLN) was positive for malignancy, so further dissections up to the low-axilla (lateral area from the border of pectoralis minor muscle) was added. She received modified radical mastectomy. Additionally, she had the operation for right breast cancer 46 months before, which was incidentally detected by CT for checking-up after the colon cancer operation. She has also suffered from congenital right hip dislocation and had received artificial bone head replacement for left metamorphous hip-joint disease. She had undergone the surgeries for transverse colon cancer (pathological T3N0M0: Stage II) and gastric cancer (pT1aN0M0: Stage IA) concomitantly performed by laparotomy 7 years before, and she had also received caesarian sections two times in her 20 s, hysterectomy for myoma in her 30 s, and mesh repair of incisional hernia by laparotomy 4 years before. Because, in this case, the metastasis was relevant to neither breast surgery nor radiation, the previously performed prolific surgeries could influence the alterations of lymphatic pathways. However, the present case as metastasizing to the contralateral inguinal lymph node is far rarer. Indeed, there have been several reports showing the contralateral axillary or intramammary lymph node metastases. The study of preoperative lymphoscintigraphies for the patients with ipsilateral breast cancer recurrences showed that aberrant lymphatic drainages were relatively common in patients with ALND and/or RT. These lymphatic pathways have been reported to be altered after the treatments such as axillary lymph node dissection (ALND) and/or radiation (RT). ![]() It also tends to invade through the lymphatic chains mainly to the axillary nodes or occasionally to the internal mammary nodes. One of the causes of this complex metastatic pattern is thought be ascribed to the previously performed prolific abdominal operations.īreast cancer is well known to metastasize to the entire organs by hematological spread to such as the bone, lung, liver, and the brain and so on. Besides, this is the first case showing the contralateral spread to the primary breast cancer. This is the sixth case having been reported in English literature. Pathological findings revealed them being compatible with breast cancer origin. She underwent inguinal lymph node dissections. The progression pattern of inguinal lymph node metastases had much correlated with that of the breast cancer. Although the metastases were firstly detected 46 months after the breast surgery, they had already existed at the time of the breast operation, which was retrospectively re-evaluated by CT examination. Previously, she had received five times abdominal operations and left artificial bone head replacement for metamorphous hip-joint disease. We have experienced a case of an 82-year-old woman showing left inguinal lymph node metastases from right breast cancer. However, inguinal lymph node metastasis from breast cancer is extremely rare. Breast cancer is well known to tends to invade through the lymphatic chains mainly to the axillary and subclavian nodes or occasionally to the internal mammary nodes.
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