Extensive systemic and cutaneous metastasis – Extremely rare presentation of breast carcinoma

Cutaneous metastases from systemic malignancy are relatively uncommon. Breast carcinoma is one of the most common cancer in women which metastasize to skin. Skin metastasis found in 0.7% to 10.4% of all patient with systemic malignancy. Here we report a 36-year-old lady with advanced primary ductal carcinoma of right breast ( T4N1M1 ) stage 4 disease who presented us with 1 year history of right breast lump, progress from small 2 cm nodule in right breast, remain static for another 9 months and then suddenly progress to recent size of 15 × 15 cm with development of multiple skin swelling in abdomen, back, upper arm, and right thigh region simultaneously. These skin nodules are clinically mimicking lipoma. There is multiple mobile lump in left breast also mimicking fibroadenoma which are increasing in size and number in last 3 months. These swelling in skin and opposite breast are turn out to be metastatic nodules after histopathology report. After radiological examination metastatic nodules found in liver and spleen too. Mammography shows BIRADS 5 in bilateral breast. Patient was put on neoadjuvant chemotherapy. First cycle of paclitaxel based chemotherapy was started after histological confirmation.