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Giménez et al. J Cancer Metastasis Treat 2019;5:28 Journal of Cancer
DOI: 10.20517/2394-4722.2018.75 Metastasis and Treatment

Case Report Open Access

Contralateral axillary metastasis: is surgical
treatment the best option?

María Julia Giménez, Jesús Manuel Patrón, Giovanni Vento, Ana Bayón, Vincenzo Maisto, Isidro Bolumar,
Rosa Ferrer, Josep Asensi, Joaquin Gavila, Rafael Estevan

Department of Surgery, Fundación Instituto Valenciano de Oncología (IVO), Valencia 46007, España.

Correspondence to: Dr. María Julia Giménez, Department of Surgery, Fundación Instituto Valenciano de Oncología (IVO),
Valencia 46007, España. E-mail: julia.gimenezcliment@gmail.com

How to cite this article: Giménez MJ, Patrón JM, Vento G, Bayón A, Maisto V, Bolumar I, Ferrer R, Asensi J, Gavila J, Estevan R.
Contralateral axillary metastasis: is surgical treatment the best option? J Cancer Metastasis Treat 2019;5:28.
http://dx.doi.org/10.20517/2394-4722.2018.75
Received: 15 Nov 2018 First Decision: 13 Feb 2019 Revised: 20 Feb 2019 Accepted: 21 Feb 2019 Published: 8 Apr 2019

Science Editor: Schiemann William Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
Contralateral axillary metastasis (CAM) is a rare entity normally treated as a systemic disease. Recent publications
have proposed aggressive surgical treatment with benefits to the patients in terms of survival. We present a case
of a 74-year-old patient with a history of unilateral breast cancer, recurrence on the ipsilateral breast and then
development of a CAM. The patient was treated with aggressive surgical treatment, but she developed an early
recurrence of the disease with distant metastasis. There is limited evidence of the correct management of CAM,
although proposed to treat it as a loco regional disease, individualized and multidisciplinary management is the best
option for these patients.

Keywords: Breast cancer, contralateral axillary metastasis, lymphatic routes blockage

INTRODUCTION
Contralateral axillary metastasis (CAM), posterior to a unilateral breast cancer, is a rare entity. The reported
[1,2]
incidence is between 1.9% and 6% in different publications . Although rare, it is very clinically relevant,
as lymph node metastasis is the most important prognostic factor in breast cancer. Correct identification
of the primary origin of axillary metastasis is a priority; however, sometimes it can be a true challenge.
There are many controversies about the pathophysiology and appropriate management of CAM because
the contralateral axilla is considered a distant metastasis, thus stage IV disease, with limited therapeutic

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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