Article Text

Download PDFPDF
Contralateral axillary metastasis: a diagnostic and therapeutic clinical dilemma
  1. Hussain Adnan Abdulla,
  2. Asma AlQaseer,
  3. Zain Bukamal and
  4. Amal Alrayes
  1. Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
  1. Correspondence to Dr Hussain Adnan Abdulla; hussainaabdulla{at}


We report a 61-year-old woman with primary right breast cancer and metastatic lymphadenopathy in the contralateral axilla. This case represents a clinical dilemma because primary breast cancer, occult contralateral breast cancer and extra-mammary primary lesion can all be the source of the contralateral axillary metastasis. The patient underwent bilateral modified radical mastectomy. Immunohistochemistry revealed that the right breast was positive for estrogen receptor (ER) and progesterone receptor (PR), but negative for human epidermal growth factor receptor-2 (HER2). In contrast, the right and left axillary lymph nodes were positive for ER, but negative for PR and HER2. There was no evidence of occult primary cancers or extra-mammary tumours.

  • breast cancer
  • breast surgery
  • surgical oncology

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors HA and AA wrote the manuscript. ZB was responsible for editing the manuscript. AA, the consultant surgeon responsible for the patient’s care, revised the manuscript and gave it final approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.