Metastases to the female genital tract from breast cancer are unusual.
Defining “breast unusual metastasis” as rare systemic failure with a frequency of <1%
Lobular histotype seems to metastasize to the genital tract more frequently than ductal tumors
], probably for an hematogenous propagation.
Few cases are reported in literature describing isolated metastasis to the cervix
]. To our knowledge, this is the first case of an isolated
vaginal relapse from breast cancer treated by surgery.
Data regarding vaginal metastasis behavior and treatment are scarce. Most of the cases are treated by radiotherapy
]. In our opinion, surgery is a valid alternative to radiotherapy , and the absence of relevant side effects or complication and the current status of our patient corroborate this strategy.
Furthermore, this case report suggests that cancer survivors should be subjected to a more thorough gynecologic examination. Although a baseline gynecologic assessment is recommended prior to administration of the cancer risk reduction agents (Tamoxifen), and follow up gynecologic assessment should be performed at each visit, as assess by NCCN Guidelines, currently gynecological counseling is not universally part of breast cancer follow up workup.
Globally our experience highlights that breast cancer survivors deserve a periodic gynecological assessment as part of their regular follow up. Also, we can assume that recurrent disease would have been undetected if deeper evaluations had not be carried out and that when it occurs surgery could be a rationale choice of treatment.
In conclusion, in our opinion, in case of recurrence in female genital tract an expert Gynecologic Oncology Surgeon should be consulted.