Ovarian Cancer Metastasis to the Breast: Radiologic-Pathologic Correlation

Ovarian metastasis to the breast is extremely rare. The clinical and radiologic presentation of metastasis to the breast is nonspecific and can mimic primary breast cancers. The most common mammographic findings of ovarian metastasis are superficial, circumscribed, high-density masses without architectural distortion. Compared with other malignancies that metastasize to the breast, ovarian cancer can more frequently show microcalcifications. On US, these masses can be hypoechoic or have heterogeneous echogenicity with posterior acoustic enhancement. Less commonly, ovarian metastasis can present similarly to inflammatory breast cancer, demonstrating diffuse skin thickening on mammography and US. Immunohistochemistry is useful in differentiating ovarian metastasis from primary breast lesions. Ovarian and breast markers, including Wilm's tumor, paired box 8, cancer antigen 125, GATA binding protein 3, and gross cystic disease fluid protein 15, are particularly helpful. Overall, metastatic ovarian cancer to the breast provides a diagnostic challenge requiring close radiologic and pathologic correlation to reach the correct diagnosis.